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<meta name="DC.Title" content="Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8271" />
<meta name="DC.Date" content="2024-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: MS lesions exhibit varying degrees of axonal and myelin damage. A comprehensive description of lesion phenotypes could contribute to an improved radiologic evaluation of smoldering inflammation and remyelination processes. This study aimed to identify in vivo distinct MS lesion types using quantitative susceptibility mapping and susceptibility mapping–weighted imaging and to characterize them through T1-relaxometry, myelin mapping, and diffusion MR imaging. The spatial distribution of lesion phenotypes in relation to ventricular CSF was investigated.

MATERIALS AND METHODS: MS lesions of 53 individuals were categorized into iso- or hypointense lesions, hyperintense lesions, and paramagnetic rim lesions, on the basis of their appearance on quantitative susceptibility mapping alone, according to published criteria, and with the additional support of susceptibility mapping–weighted imaging. Susceptibility values, T1-relaxation times, myelin and free water fractions, intracellular volume fraction, and the orientation dispersion index were compared among lesion phenotypes. The distance of the geometric center of each lesion from the ventricular CSF was calculated.

RESULTS: Eight hundred ninety-six MS lesions underwent the categorization process using quantitative susceptibility mapping and susceptibility mapping–weighted imaging. The novel use of susceptibility mapping–weighted images, which revealed additional microvasculature details, led us to re-allocate several lesions to different categories, resulting in a 35.6% decrease in the number of paramagnetic rim lesions, a 22.5% decrease in hyperintense lesions, and a 17.2% increase in iso- or hypointense lesions, with respect to the categorization based on quantitative susceptibility mapping only. The outcome of the categorization based on the joint use of quantitative susceptibility mapping and susceptibility mapping–weighted imaging was that 44.4% of lesions were iso- or hypointense lesions, 47.9% were hyperintense lesions, and 7.7% were paramagnetic rim lesions. A worsening gradient was observed from iso- or hypointense lesions to hyperintense lesions to paramagnetic rim lesions in T1-relaxation times, myelin water fraction, free water fraction, and intracellular volume fraction. Paramagnetic rim lesions were located closer to ventricular CSF than iso- or hypointense lesions. The volume of hyperintense lesions was associated with a more severe disease course.

CONCLUSIONS: Quantitative susceptibility mapping and susceptibility mapping–weighted imaging allow in vivo classification of MS lesions into different phenotypes, characterized by different levels of axonal and myelin loss and spatial distribution. Hyperintense lesions and paramagnetic rim lesions, which have the most severe microstructural damage, were more often observed in the periventricular WM and were associated with a more severe disease course.

ARMSS
:   Age-Related MS Severity Score
EDSS
:   Expanded Disability Status Scale
FWF
:   free water fraction
HC
:   healthy control
HYPER
:   hyperintense lesions
ISO-HYPO
:   iso- or hypointense lesions
ICVF
:   intracellular volume fraction
MWF
:   myelin water fraction
ODI
:   orientation dispersion index
PRL
:   paramagnetic rim lesion
QSM
:   quantitative susceptibility mapping
SMWI
:   susceptibility mapping–weighted imaging" />
<meta name="DC.Contributor" content="Francesco Tazza" />
<meta name="DC.Contributor" content="Giacomo Boffa" />
<meta name="DC.Contributor" content="Simona Schiavi" />
<meta name="DC.Contributor" content="Caterina Lapucci" />
<meta name="DC.Contributor" content="Gian Franco Piredda" />
<meta name="DC.Contributor" content="Emilio Cipriano" />
<meta name="DC.Contributor" content="Domenico Zacà" />
<meta name="DC.Contributor" content="Luca Roccatagliata" />
<meta name="DC.Contributor" content="Tom Hilbert" />
<meta name="DC.Contributor" content="Tobias Kober" />
<meta name="DC.Contributor" content="Matilde Inglese" />
<meta name="DC.Contributor" content="Mauro Costagli" />
<meta name="article:published_time" content="2024-08-01" />
<meta name="article:section" content="Ultra-High-Field MRI/Imaging of Epilepsy/Demyelinating Diseases/Inflammation/Infection" />
<meta name="citation_title" content="Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;MS lesions exhibit varying degrees of axonal and myelin damage. A comprehensive description of lesion phenotypes could contribute to an improved radiologic evaluation of smoldering inflammation and remyelination processes. This study aimed to identify in vivo distinct MS lesion types using quantitative susceptibility mapping and susceptibility mapping–weighted imaging and to characterize them through T1-relaxometry, myelin mapping, and diffusion MR imaging. The spatial distribution of lesion phenotypes in relation to ventricular CSF was investigated.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;MS lesions of 53 individuals were categorized into iso- or hypointense lesions, hyperintense lesions, and paramagnetic rim lesions, on the basis of their appearance on quantitative susceptibility mapping alone, according to published criteria, and with the additional support of susceptibility mapping–weighted imaging. Susceptibility values, T1-relaxation times, myelin and free water fractions, intracellular volume fraction, and the orientation dispersion index were compared among lesion phenotypes. The distance of the geometric center of each lesion from the ventricular CSF was calculated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Eight hundred ninety-six MS lesions underwent the categorization process using quantitative susceptibility mapping and susceptibility mapping–weighted imaging. The novel use of susceptibility mapping–weighted images, which revealed additional microvasculature details, led us to re-allocate several lesions to different categories, resulting in a 35.6% decrease in the number of paramagnetic rim lesions, a 22.5% decrease in hyperintense lesions, and a 17.2% increase in iso- or hypointense lesions, with respect to the categorization based on quantitative susceptibility mapping only. The outcome of the categorization based on the joint use of quantitative susceptibility mapping and susceptibility mapping–weighted imaging was that 44.4% of lesions were iso- or hypointense lesions, 47.9% were hyperintense lesions, and 7.7% were paramagnetic rim lesions. A worsening gradient was observed from iso- or hypointense lesions to hyperintense lesions to paramagnetic rim lesions in T1-relaxation times, myelin water fraction, free water fraction, and intracellular volume fraction. Paramagnetic rim lesions were located closer to ventricular CSF than iso- or hypointense lesions. The volume of hyperintense lesions was associated with a more severe disease course.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Quantitative susceptibility mapping and susceptibility mapping–weighted imaging allow in vivo classification of MS lesions into different phenotypes, characterized by different levels of axonal and myelin loss and spatial distribution. Hyperintense lesions and paramagnetic rim lesions, which have the most severe microstructural damage, were more often observed in the periventricular WM and were associated with a more severe disease course.&lt;/p&gt;" />
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<meta name="twitter:title" content="Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: MS lesions exhibit varying degrees of axonal and myelin damage. A comprehensive description of lesion phenotypes could contribute to an improved radiologic evaluation of smoldering inflammation and remyelination processes. This study aimed to identify in vivo distinct MS lesion types using quantitative susceptibility mapping and susceptibility mapping–weighted imaging and to characterize them through T1-relaxometry, myelin mapping, and diffusion MR imaging. The spatial distribution of lesion phenotypes in relation to ventricular CSF was investigated.

MATERIALS AND METHODS: MS lesions of 53 individuals were categorized into iso- or hypointense lesions, hyperintense lesions, and paramagnetic rim lesions, on the basis of their appearance on quantitative susceptibility mapping alone, according to published criteria, and with the additional support of susceptibility mapping–weighted imaging. Susceptibility values, T1-relaxation times, myelin and free water fractions, intracellular volume fraction, and the orientation dispersion index were compared among lesion phenotypes. The distance of the geometric center of each lesion from the ventricular CSF was calculated.

RESULTS: Eight hundred ninety-six MS lesions underwent the categorization process using quantitative susceptibility mapping and susceptibility mapping–weighted imaging. The novel use of susceptibility mapping–weighted images, which revealed additional microvasculature details, led us to re-allocate several lesions to different categories, resulting in a 35.6% decrease in the number of paramagnetic rim lesions, a 22.5% decrease in hyperintense lesions, and a 17.2% increase in iso- or hypointense lesions, with respect to the categorization based on quantitative susceptibility mapping only. The outcome of the categorization based on the joint use of quantitative susceptibility mapping and susceptibility mapping–weighted imaging was that 44.4% of lesions were iso- or hypointense lesions, 47.9% were hyperintense lesions, and 7.7% were paramagnetic rim lesions. A worsening gradient was observed from iso- or hypointense lesions to hyperintense lesions to paramagnetic rim lesions in T1-relaxation times, myelin water fraction, free water fraction, and intracellular volume fraction. Paramagnetic rim lesions were located closer to ventricular CSF than iso- or hypointense lesions. The volume of hyperintense lesions was associated with a more severe disease course.

CONCLUSIONS: Quantitative susceptibility mapping and susceptibility mapping–weighted imaging allow in vivo classification of MS lesions into different phenotypes, characterized by different levels of axonal and myelin loss and spatial distribution. Hyperintense lesions and paramagnetic rim lesions, which have the most severe microstructural damage, were more often observed in the periventricular WM and were associated with a more severe disease course.

ARMSS
:   Age-Related MS Severity Score
EDSS
:   Expanded Disability Status Scale
FWF
:   free water fraction
HC
:   healthy control
HYPER
:   hyperintense lesions
ISO-HYPO
:   iso- or hypointense lesions
ICVF
:   intracellular volume fraction
MWF
:   myelin water fraction
ODI
:   orientation dispersion index
PRL
:   paramagnetic rim lesion
QSM
:   quantitative susceptibility mapping
SMWI
:   susceptibility mapping–weighted imaging" />
<meta name="og-title" property="og:title" content="Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/8/1166" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: MS lesions exhibit varying degrees of axonal and myelin damage. A comprehensive description of lesion phenotypes could contribute to an improved radiologic evaluation of smoldering inflammation and remyelination processes. This study aimed to identify in vivo distinct MS lesion types using quantitative susceptibility mapping and susceptibility mapping–weighted imaging and to characterize them through T1-relaxometry, myelin mapping, and diffusion MR imaging. The spatial distribution of lesion phenotypes in relation to ventricular CSF was investigated.

MATERIALS AND METHODS: MS lesions of 53 individuals were categorized into iso- or hypointense lesions, hyperintense lesions, and paramagnetic rim lesions, on the basis of their appearance on quantitative susceptibility mapping alone, according to published criteria, and with the additional support of susceptibility mapping–weighted imaging. Susceptibility values, T1-relaxation times, myelin and free water fractions, intracellular volume fraction, and the orientation dispersion index were compared among lesion phenotypes. The distance of the geometric center of each lesion from the ventricular CSF was calculated.

RESULTS: Eight hundred ninety-six MS lesions underwent the categorization process using quantitative susceptibility mapping and susceptibility mapping–weighted imaging. The novel use of susceptibility mapping–weighted images, which revealed additional microvasculature details, led us to re-allocate several lesions to different categories, resulting in a 35.6% decrease in the number of paramagnetic rim lesions, a 22.5% decrease in hyperintense lesions, and a 17.2% increase in iso- or hypointense lesions, with respect to the categorization based on quantitative susceptibility mapping only. The outcome of the categorization based on the joint use of quantitative susceptibility mapping and susceptibility mapping–weighted imaging was that 44.4% of lesions were iso- or hypointense lesions, 47.9% were hyperintense lesions, and 7.7% were paramagnetic rim lesions. A worsening gradient was observed from iso- or hypointense lesions to hyperintense lesions to paramagnetic rim lesions in T1-relaxation times, myelin water fraction, free water fraction, and intracellular volume fraction. Paramagnetic rim lesions were located closer to ventricular CSF than iso- or hypointense lesions. The volume of hyperintense lesions was associated with a more severe disease course.

CONCLUSIONS: Quantitative susceptibility mapping and susceptibility mapping–weighted imaging allow in vivo classification of MS lesions into different phenotypes, characterized by different levels of axonal and myelin loss and spatial distribution. Hyperintense lesions and paramagnetic rim lesions, which have the most severe microstructural damage, were more often observed in the periventricular WM and were associated with a more severe disease course.

ARMSS
:   Age-Related MS Severity Score
EDSS
:   Expanded Disability Status Scale
FWF
:   free water fraction
HC
:   healthy control
HYPER
:   hyperintense lesions
ISO-HYPO
:   iso- or hypointense lesions
ICVF
:   intracellular volume fraction
MWF
:   myelin water fraction
ODI
:   orientation dispersion index
PRL
:   paramagnetic rim lesion
QSM
:   quantitative susceptibility mapping
SMWI
:   susceptibility mapping–weighted imaging" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node109281--5" data-node-nid="109281" id="top-node-109281--6584936271" data-pisa="ajnr;45/8/1166" data-pisa-master="ajnr;ajnr.A8271" data-apath="/ajnr/45/8/1166.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Ultra-High-Field MRI/Imaging of Epilepsy/Demyelinating Diseases/Inflammation/Infection</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Francesco Tazza</span>, <span class="highwire-citation-author" data-delta="1">Giacomo Boffa</span>, <span class="highwire-citation-author" data-delta="2">Simona Schiavi</span>, <span class="highwire-citation-author" data-delta="3">Caterina Lapucci</span>, <span class="highwire-citation-author" data-delta="4">Gian Franco Piredda</span>, <span class="highwire-citation-author" data-delta="5">Emilio Cipriano</span>, <span class="highwire-citation-author" data-delta="6">Domenico Zacà</span>, <span class="highwire-citation-author" data-delta="7">Luca Roccatagliata</span>, <span class="highwire-citation-author" data-delta="8">Tom Hilbert</span>, <span class="highwire-citation-author" data-delta="9">Tobias Kober</span>, <span class="highwire-citation-author" data-delta="10">Matilde Inglese</span> and <span class="highwire-citation-author" data-delta="11">Mauro Costagli</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1166-1174; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8271 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-109281--6584936271" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Francesco Tazza </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (F.T., G.B., S.S., E.C., M.I., M.C.), University of Genoa, Genoa, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Francesco%2BTazza%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tazza%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AFrancesco%2BTazza%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3515-3475" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Francesco Tazza</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Giacomo Boffa </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (F.T., G.B., S.S., E.C., M.I., M.C.), University of Genoa, Genoa, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a 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class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (F.T., G.B., S.S., E.C., M.I., M.C.), University of Genoa, Genoa, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Simona%2BSchiavi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schiavi%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ASimona%2BSchiavi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Caterina Lapucci </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Istituto di Ricovero e Cura a Carattere Scientifico (C.L., L.R., M.I., M.C.), Ospedale Policlinico San Martino, Genoa, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Caterina%2BLapucci%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lapucci%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a 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class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Emilio%2BCipriano%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cipriano%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AEmilio%2BCipriano%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">Domenico Zacà </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Siemens Healthcare (D.Z.), Milan, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Domenico%2BZac%C3%A0%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zac%C3%A0%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ADomenico%2BZac%25C3%25A0%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">Luca Roccatagliata </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Istituto di Ricovero e Cura a Carattere Scientifico (C.L., L.R., M.I., M.C.), Ospedale Policlinico San Martino, Genoa, Italy</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Health Sciences (L.R.), University of Genoa, Genoa, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Luca%2BRoccatagliata%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Roccatagliata%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ALuca%2BRoccatagliata%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on 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Switzerland</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology (T.H., T.K.), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland</div><div class='author-affiliation'><span class='nlm-sup'>e</span>LTS5 (T.H., T.K.), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Tobias%2BKober%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kober%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ATobias%2BKober%2B" rel="nofollow" class="" 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class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (F.T., G.B., S.S., E.C., M.I., M.C.), University of Genoa, Genoa, Italy</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Istituto di Ricovero e Cura a Carattere Scientifico (C.L., L.R., M.I., M.C.), Ospedale Policlinico San Martino, Genoa, Italy</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Mauro%2BCostagli%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Costagli%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-45.8.1166.1" data-doi="10.1007/s00401-016-1653-y"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Kuhlmann</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ludwin</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Prat</span>  <span class="cit-name-given-names">A</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">An updated histological 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2024 </div></div>
      
      
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      <div class="highwire-cite-title">Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Francesco</span> <span class="nlm-surname">Tazza</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Giacomo</span> <span class="nlm-surname">Boffa</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Simona</span> <span class="nlm-surname">Schiavi</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Caterina</span> <span class="nlm-surname">Lapucci</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Gian Franco</span> <span class="nlm-surname">Piredda</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Emilio</span> <span class="nlm-surname">Cipriano</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Domenico</span> <span class="nlm-surname">Zacà</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Luca</span> <span class="nlm-surname">Roccatagliata</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Tom</span> <span class="nlm-surname">Hilbert</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Tobias</span> <span class="nlm-surname">Kober</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Matilde</span> <span class="nlm-surname">Inglese</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Mauro</span> <span class="nlm-surname">Costagli</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1166-1174; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8271 </span></div>
  
  
  
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      <div class="highwire-cite-title">Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Francesco</span> <span class="nlm-surname">Tazza</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Giacomo</span> <span class="nlm-surname">Boffa</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Simona</span> <span class="nlm-surname">Schiavi</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Caterina</span> <span class="nlm-surname">Lapucci</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Gian Franco</span> <span class="nlm-surname">Piredda</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Emilio</span> <span class="nlm-surname">Cipriano</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Domenico</span> <span class="nlm-surname">Zacà</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Luca</span> <span class="nlm-surname">Roccatagliata</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Tom</span> <span class="nlm-surname">Hilbert</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Tobias</span> <span class="nlm-surname">Kober</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Matilde</span> <span class="nlm-surname">Inglese</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Mauro</span> <span class="nlm-surname">Costagli</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1166-1174; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8271 </span></div>
  
  
  
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