{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:20:05Z","timestamp":1792668005852,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND AND PURPOSE<\/jats:title><jats:p>Meningeal inflammation is implicated in cortical demyelination and disability progression in multiple sclerosis (MS). Gadolinium (Gd)\u2010enhanced 3\u2010dimensional (3D) FLAIR (fluid\u2010attenuated inversion recovery) magnetic resonance imaging (MRI) can identify leptomeningeal enhancement (LME) in MS. Further characterization is needed to determine if LME is an imaging biomarker for meningeal inflammation. We sought to characterize the natural history of LME in the community setting, including persistence\/resolution, effect of disease\u2010modifying therapy, scanner variability, timing of acquisition, and imaging pitfalls that may lead to misinterpretation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 341 MRI exams with Gd\u2010enhanced 3D\u2010FLAIR were reviewed in MS and non\u2010MS patients to determine frequency of enhancement by MS subtype and association with therapy. A phantom was used to assess scanner variability. Two MS patients with seven LME were imaged at four postinjection time points to generate time\u2010intensity curves. Imaging pitfalls were compiled.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 16.6% (40\/241) of MS patients revealed LME compared to 8% (8\/100) in non\u2010MS patients (<jats:italic>P<\/jats:italic> = .04). There was no association with MS subtype, therapy, or disease activity. Detection using General Electric's version of 3D\u2010FLAIR (29%) was greater than with Siemen's 3D\u2010FLAIR (12%) at 1.5T (Tesla) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Lesions were generally stable but resolved in 2 patients following high\u2010dose steroids. LME kinetics were heterogeneous, even within patients, without uniform optimal time for acquisition. Enhancement curves exhibited three different variations, similar to the two\u2010compartment model. Imaging pitfalls included enhancements of uncertain biologic significance, cortical veins and anatomic structures, and imaging artifacts.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Awareness of LME characteristics, variability with imaging parameters, and imaging pitfalls will facilitate determining the potential role as an imaging biomarker for meningeal inflammation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.12774","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T19:26:31Z","timestamp":1598297191000},"page":"917-929","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Leptomeningeal Enhancement on 3D\u2010FLAIR MRI in Multiple Sclerosis: Systematic Observations in Clinical Practice"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2019-4784","authenticated-orcid":false,"given":"David S.","family":"Titelbaum","sequence":"first","affiliation":[{"name":"Department of Neuroradiology Shields Health Care  Brockton MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3340-9617","authenticated-orcid":false,"given":"Renate","family":"Engisch","sequence":"additional","affiliation":[{"name":"Department of Radiology Spital Zofingen  Zofingen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3954-4780","authenticated-orcid":false,"given":"Eric D.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Radiology St. Elizabeth's Medical Center  Brighton MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7713-7983","authenticated-orcid":false,"given":"Salvatore Q.","family":"Napoli","sequence":"additional","affiliation":[{"name":"Department of Neurology Neurology Center of New England  Foxboro MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0028-3031","authenticated-orcid":false,"given":"Jacob A.","family":"Sloane","sequence":"additional","affiliation":[{"name":"Department of Neurology Beth Israel Deaconess Medical Center  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0545-6114","authenticated-orcid":false,"given":"Soleil","family":"Samaan","sequence":"additional","affiliation":[{"name":"Department of Neurology Beth Israel Deaconess Medical Center  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-5232","authenticated-orcid":false,"given":"Joshua D.","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Neurology The Elliot Lewis Center for MS Care  Wellesley MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8293-6819","authenticated-orcid":false,"given":"Ellen S.","family":"Lathi","sequence":"additional","affiliation":[{"name":"Department of Neurology The Elliot Lewis Center for MS Care  Wellesley 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