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      <h1 class="highwire-cite-title" id="page-title">Low Signals on T2* and SWI Sequences in Patients with MS with Progressive Multifocal Leukoencephalopathy</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Labauge</span>, <span class="highwire-citation-author" data-delta="1">C. Carra-Dalliere</span>, <span class="highwire-citation-author" data-delta="2">X. Ayrignac</span> and <span class="highwire-citation-author" data-delta="3">N. Menjot de Champfleur</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">February 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E11; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4632 </span></div>
  
  
  
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<div id="hw-article-author-popups-node-14246--2100755463" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P. Labauge </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Neurology</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=P.%2BLabauge%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=Labauge%20P&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%3AP.%2BLabauge%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="http://orcid.org/0000-0001-7759-8555" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Labauge</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C. Carra-Dalliere </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Neurology</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=C.%2BCarra-Dalliere%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=Carra-Dalliere%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 href="/search/author1%3AC.%2BCarra-Dalliere%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="http://orcid.org/0000-0002-0985-3662" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Carra-Dalliere</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">X. Ayrignac </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Neurology</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=X.%2BAyrignac%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=Ayrignac%20X&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%3AX.%2BAyrignac%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="http://orcid.org/0000-0003-3834-2981" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Ayrignac</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">N. Menjot de Champfleur </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department Neuroradiology
Montpellier University Hospital
Centre Hospitalo-Universitair Gui de Chauliac
Montpellier, France</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=N.%2BMenjot%2Bde%2BChampfleur%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=Menjot%20de%20Champfleur%20N&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%3AN.%2BMenjot%2Bde%2BChampfleur%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="http://orcid.org/0000-0002-4098-5962" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Menjot de Champfleur</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-1">We read with interest the study by Hodel et al<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> concerning the occurrence of cortex, U-fiber, and basal ganglia low signals found on T2* and SWI sequences in 12 patients with MS with progressive multifocal leukoencephalopathy (PML). These low signals were frequent in this series and may occur in presymptomatic patients with PML treated with natalizumab (75% of their 8 asymptomatic patients with PML). We previously published such low intensities in a patient with a PML diagnosis.<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup> We further confirmed the importance of T2* and SWI sequences to detect low signals in a series of 4 patients with PML.<sup><a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a></sup> Pathologic analysis by Hodel et al<sup><a id="xref-ref-1-2" class="xref-bibr" href="#ref-1">1</a></sup> of a patient with low T2* signal intensities identified astrocytic gliosis associated with abundant microglial and macrophage infiltrates, containing myelin-filled vacuoles. The authors hypothesized that low signal on T2* could be related to accumulation of iron in the macrophages. Although T2* and SWI low signal intensities are not constant in PML, their occurrence may differentiate confluent MS lesions from PML. Consequently, an MR imaging survey of patients at risk for PML (notably patients with MS treated with natalizumab or those who are immunosuppressed) should include T2* and SWI sequences.</p><div 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><div class="cit ref-cit ref-journal" id="cit-37.2.E11.1" data-doi="10.3174/ajnr.A4436"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Hodel</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Outteryck</span>  <span class="cit-name-given-names">O</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Verclytte</span>  <span class="cit-name-given-names">S</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Brain magnetic susceptibility changes in patients with natalizumab-associated progressive multifocal leukoencephalopathy</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2015</span> 
<span class="cit-month">Aug</span> 
<span class="cit-day">27</span>. <span class="cit-comment">[Epub ahead of print]</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A4436</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>26316568</span></cite></div></div></li><li><span class="ref-label">2.</span><div class="cit ref-cit ref-journal" id="cit-37.2.E11.2" data-doi="10.1212/WNL.0000000000001455"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Carra-Dalliere</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Menjot de Champfleur</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ayrignac</span>  <span class="cit-name-given-names">X</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Quantitative susceptibility mapping suggests a paramagnetic effect in PML</span>. <abbr class="cit-jnl-abbrev">Neurology</abbr> <span class="cit-pub-date">2015</span>;<span class="cit-vol">84</span>:<span class="cit-fpage">1501</span>–<span class="cit-lpage">02</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1212/WNL.0000000000001455</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>25846998</span></cite></div></div></li><li><span class="ref-label">3.</span><div class="cit ref-cit ref-journal" id="cit-37.2.E11.3" data-doi="10.1016/j.neurad.2015.08.001"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Carra-Dalliere</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Menjot de Champfleur</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Deverdun</span>  <span class="cit-name-given-names">J</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Use of quantitative susceptibility mapping (QSM) in progressive multifocal leukoencephalopathy</span>. <abbr class="cit-jnl-abbrev">J Neuroradiol</abbr> <span class="cit-pub-date">2015</span> 
<span class="cit-month">Oct</span> 
<span class="cit-day">13</span>. <span class="cit-comment">[Epub ahead of print]</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.neurad.2015.08.001</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>26475668</span></cite></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2016 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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