Multiple sclerosis: serial study of gadolinium-enhanced MR imaging.
Thirteen patients with definite multiple sclerosis (MS), studied 16-24 months previously with magnetic resonance (MR) imaging with and without enhancement by intravenously administered gadolinium diethylenetriaminepentaacetic acid (DTPA) dimeglumine, were reexamined with a similar protocol. Assessment of enhancement and clinical activity in both studies revealed that enhancement was observed in 13 of 14 cases in which clinical activity had changed within 4 weeks of the study and thus appeared more sensitive than clinical examination in determining active disease. The 3-minute postinjection, short repetition time image (TR) was the most efficient for depicting enhancement. Enhancing lesions (active plaques) arose from previously hyper- or isointense regions on long TR images. Previously active lesions reverted to areas of iso- or hyperintensity on long TR images. Serial comparison of long TR images in this population reveals a decrease in high-intensity lesions on long TR images in some cases and an increase in others. The findings of high-intensity regions on long TR images and previously enhancing lesions both becoming isointense suggests that transient inflammatory changes with concomitant edema without demyelination and/or with significant remyelination may occur in some MS lesions. MS lesions are dynamic; both active and inactive lesions may show dramatic change on longitudinal MR imaging studies.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
R I
RI
Grossman
B H
BH
Braffman
J R
JR
Brorson
H I
HI
Goldberg
D H
DH
Silberberg
F
F
Gonzalez-Scarano
D000328:Adult; D000368:Aged; D001812:Blood-Brain Barrier; D001921:Brain / Q000473:pathology*; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D009942:Organometallic Compounds; D004369:Pentetic Acid; D013012:Sorbitol / Q000031:analogs & derivatives*; D013997:Time Factors
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D013012:Sorbitol; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA