A one year study of new lesions in multiple sclerosis using monthly gadolinium enhanced MRI: correlations with changes of T2 and magnetization transfer lesion loads.
In this study, 14 patients with either relapsing-remitting or secondary progressive multiple sclerosis (MS) were scanned monthly using gadolinium enhanced magnetic resonance imaging (MRI). At the start of the study and at 1 year follow up, T2-weighted and magnetization transfer (MT) scans were also performed. The correlation between the frequency and extent of enhancement and changes of lesion load over a 1 year period on T2-weighted and MT images were assessed. For all patients, and for the relapsing-remitting patients only, the number and volume of enhancing lesions per month showed no significant correlation with the change between baseline and 1 year follow up of lesion volumes on T2 and MT images. However, strong correlations were found between the number and volume of gadolinium enhancing lesions with changes of T2 (r = 0.93, P = 0.02) and MT (r = 0.82, P = 0.04) lesion loads in patients with secondary progressive MS. Strong correlations were also found between the lesion loads on T2-weighted scans and on MT images both at baseline and at 1 year follow up (r = 0.83, P = 0.003). In addition, the changes in lesion load over 1 year, detected using the two techniques, were moderately correlated (r = 0.51, P = 0.05). This study provides further evidence that the pathological processes in MS are at different stages in relapsing-remitting and secondary progressive MS. It also suggests that the effectiveness of recovery mechanisms within lesions might be one of the major factors responsible for such a difference.
Department of Neurology, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
M
M
Filippi
M A
MA
Rocca
M A
MA
Horsfield
G
G
Comi
D000328:Adult; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000503:physiopathology; D012008:Recurrence; D013997:Time Factors
D003287:Contrast Media; D005682:Gadolinium