Development of hypointense lesions on T1-weighted spin-echo magnetic resonance images in multiple sclerosis: relation to inflammatory activity.
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.
van Walderveen
M A
MA
Magnetic Resonance Center for Multiple Sclerosis Research, Department of Radiology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands. m.vanwalderveen@azvu.nl
Truyen
L
L
van Oosten
B W
BW
Castelijns
J A
JA
Lycklama à Nijeholt
G J
GJ
van Waesberghe
J H
JH
Polman
C
C
Barkhof
F
F
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
D005682:Gadolinium