[Magnetic resonance imaging in multiple sclerosis].
Useful characteristics of MRI finding of multiple sclerosis (MS) include the distribution of lesions such as a strictly periventricular, infratentorial, or juxtacortical location, involvement of the corpus callosum and the presence of ovoid lesions with long axis directed to lateral ventricles. Our MRI-diagnostic criteria improved the sensitivity and specificity and is clinically useful. New sequences, such as fast spin echo, turbo spin echo or fluid attenuated inversion recovery have improved the detection of lesions. The presence of contrast enhancement in some but not all lesions--that is, evidence of both old and new lesions--provides additional diagnostic support. Enhanced lesions with more than 1 cm diameter often become ring-shaped. Strong correlations were found between the number and volume of enhancing lesions with changes of T 2 and magnetization transfer (MT) lesion loads in patients with secondary progressive MS. The degree of hypointensity of so called black holes on moderately T1-weighted spin echo images correlates with loss of magnetisation transfer, a marker of destruction of matrix and axon, and shows correlation with disability. One of spectroscopic indices of axonal loss is N-acetylaspartate. Atrophy is a process closely linked with the progressive phase of MS and worsening disability. Detection of the reduction in cord cross-sectional area or spinal cord atrophy over time makes an important contribution to the evaluation of therapeutic efficacy, especially in primary progressive disease.
Saida
T
T
Centre for Neurological Diseases, Utano National Hospital, Kyoto.
D001921:Brain / Q000473:pathology; D002986:Clinical Trials as Topic; D003287:Contrast Media; D005682:Gadolinium; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000628:therapy; D012015:Reference Standards
D003287:Contrast Media; D005682:Gadolinium