R Gabr*, J Lincoln, K Hasan, L Kramer, University of Texas McGovern Medical School, Houston, TX

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  R Gabr

PO-GePV-I-29 (Sunday, 7/10/2022)   [Eastern Time (GMT-4)]

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Purpose: Recent efforts to study the glymphatic function in humans have employed intrathecal and intravenous contrast injection with delayed imaging using MRI. These techniques are difficult to translate to clinical studies. This work studies the feasibility of dynamic contrast-enhanced MRI for characterization of the brain lymphatic vessels following intravenous contrast injection in routine imaging of multiple sclerosis (MS) patients.

Methods: Twenty MS patients (17 women/3 men, age 46.4±12 years) with disease duration of 13.6±9 years and Expanded Disability Status Scale (EDSS) score of 2.3±1.5 were included in this study. All subjects were scanned on a 3.0T Philips system. Coronal T2-weighted FLAIR images were acquired before administration of Gadolinium-based contrast agent (Dotarem) at standard dose of 0.1 mmol/kg. The scan was repeated seven times after contrast for 30-40 min. The signal in the lymphatic vessel was measure at all time points and the following metrics were computed to characterize the temporal dynamics of the lymphatic signal: time to peak, percent signal increase, percent residual signal, area under the curve, inflow and outflow rates.

Results: Contrast enhancement was seen in the lymph vessels on the FLAIR images. Peak enhancement was seen at ~7 min with ~100% signal increase relative to baseline. Moderate trends for a correlation were observed between the patient body mass index and percent signal increase (P=0.061) and area under the curve (P=0.082). A similar trend was observed between the patient age and percent signal increase (P=0.058). No correlations were found between the lymphatic parameters and EDSS.

Conclusion: We have demonstrated the feasibility of measuring dynamic changes in the brain lymphatic vessels following contrast administration. The proposed technique can be used in studies aiming to characterize the status of lymphatic system in the brain in neurological diseases.

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