title: Development of hypointense lesions on T1-weighted spin-echo magnetic resonance images in multiple sclerosis: relation to inflammatory activity.
abstract: OBJECTIVE
  To evaluate whether degree of inflammatory activity in multiple sclerosis, expressed by frequency of gadolinium enhancement, has prognostic value for development of hypointense lesions on T1-weighted spin-echo magnetic resonance images, a putative marker of tissue destruction.
  
  
  METHODS
  Cohort design with long-term follow-up. Thirty-eight patients with multiple sclerosis who in the past had been monitored with monthly gadolinium-enhanced magnetic resonance imaging for a median period of 10 months (range, 6-12 months) were reexamined after a median period of 40.5 months (range, 33-80 months).
  
  
  METHODS
  Magnetic Resonance Center for Multiple Sclerosis Research, Amsterdam, the Netherlands, referral center.
  
  
  METHODS
  The new enhancing lesion rate (median number of gadolinium-enhancing lesions per monthly scan) during initial monthly follow-up; hypointense T1 and hyperintense T2 lesion load at first and last visit.
  
  
  RESULTS
  The number of enhancing lesions on entry scan correlated with the new enhancing lesions rate (r = 0.64; P<.001, Spearman rank correlation coefficient). The new enhancing lesion rate correlated with yearly increase in T1 (r = 0.42; P<.01, Spearman rank correlation coefficient) and T2 (r = 0.47; P<.01, Spearman rank correlation coefficient) lesion load. Initial T1 lesion load correlated more strongly with yearly increase in T1 lesion load (r = 0.68; P<.01, Spearman rank correlation coefficient).
  
  
  CONCLUSIONS
  Degree of inflammatory activity only partially predicted increase in T1 (and T2) lesion load at long-term follow-up. Initial T1 lesion load strongly contributed to subsequent increase in hypointense T1 lesion load, suggesting that there is a subpopulation of patients with multiple sclerosis who are prone to develop destructive lesions.
authors: Magnetic Resonance Center for Multiple Sclerosis Research, Department of Radiology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands. m.vanwalderveen@azvu.nl
authors: M A
authors: MA
authors: van Walderveen
authors: L
authors: L
authors: Truyen
authors: B W
authors: BW
authors: van Oosten
authors: J A
authors: JA
authors: Castelijns
authors: G J
authors: GJ
authors: Lycklama à Nijeholt
authors: J H
authors: JH
authors: van Waesberghe
authors: C
authors: C
authors: Polman
authors: F
authors: F
authors: Barkhof
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007249:Inflammation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D011379:Prognosis
chemical_list: D005682:Gadolinium