title: Serial gadolinium enhanced magnetic resonance imaging in multiple sclerosis.
abstract: Serial gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging (MRI) was performed in 9 patients with multiple sclerosis (MS). On the first scan enhancing lesions were seen in 7 patients, all of whom were in acute relapse. Most enhancing lesions were asymptomatic. On the second scan (3 to 5 weeks later), persisting enhancement was seen in only 12/54 lesions which enhanced on the first scan. No lesion showed persisting enhancement on the third scan (after 6 months). Enhancement occurred in all 12 new lesion areas seen on the unenhanced second scan and in 8 of 15 new lesions seen on the third scan. Enhancement was also seen in 4 older lesions which had been nonenhancing on earlier scans. Relaxation time measurements demonstrated a high water content in some nonenhancing lesions, which could be due to a subtle blood-brain barrier disturbance not detected with Gd-DTPA. The results show that blood-brain barrier impairment is a consistent finding in new MS lesions detected with MRI. Gd-DTPA is a useful marker of new and biologically active lesions and should prove of value in monitoring therapeutic trials in MS.
authors.affiliation: Institute of Neurology, Queen Square, London, England.
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
authors.forename: P
authors.initials: P
authors.lastname: Rudge
authors.forename: G
authors.initials: G
authors.lastname: Johnson
authors.forename: B E
authors.initials: BE
authors.lastname: Kendall
authors.forename: D G
authors.initials: DG
authors.lastname: Macmanus
authors.forename: I F
authors.initials: IF
authors.lastname: Moseley
authors.forename: D
authors.initials: D
authors.lastname: Barnes
authors.forename: W I
authors.initials: WI
authors.lastname: McDonald
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier; D001921:Brain / Q000473:pathology*; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D009942:Organometallic Compounds / Q000009:adverse effects; D004369:Pentetic Acid / Q000009:adverse effects; D013116:Spinal Cord / Q000473:pathology; D013997:Time Factors
chemical_list: D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA