The effect of high-dose steroids on MRI gadolinium enhancement in acute demyelinating lesions.
Gadolinium (Gd) enhancement of brain lesions by MRI is a marker of active blood-brain barrier damage secondary to an inflammatory process. We studied the effects of high-dose (1,000 mg/d) intravenous (IV) methylprednisolone (Mp) for 4 to 8 days on Gd-enhancing lesions in seven patients with acute demyelinating diseases and compared pretreatment brain MRIs with studies obtained 1 to 4 days after treatment. Five patients had complete suppression, and two had significant suppression of Gd enhancement following treatment. In addition, six of seven patients had Gd-enhancing lesions that explained their clinical signs; in five of six of these patients, suppression of the Gd-enhanced lesions temporally correlated with clinical improvement. Thus, short courses of high-dose IV Mp suppress Gd enhancement in acute demyelinating lesions, and this correlates with clinical improvement.
Burnham
J A
JA
Colorado Neurological Institute, Denver.
Wright
R R
RR
Dreisbach
J
J
Murray
R S
RS
D000328:Adult; D001812:Blood-Brain Barrier / Q000187:drug effects* / Q000502:physiology; D001921:Brain / Q000473:pathology; D004679:Encephalomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D009942:Organometallic Compounds; D004369:Pentetic Acid
D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA; D008775:Methylprednisolone