title: Weekly multimodal MRI follow-up of two multiple sclerosis active lesions presenting a transient decrease in ADC.
abstract: OBJECTIVE
  Blood-brain barrier disruption during the earliest phases of lesion formation in multiple sclerosis (MS) patients is commonly ascribed to perivenular inflammatory activity and is usually accompanied by increased diffusivity. Reduced diffusivity has also been shown in active lesions, albeit less frequently. This study aimed to characterize the development and natural history of contrast-enhanced lesions by weekly following five relapsing remitting (RR) MS patients.
  
  
  METHODS
  Diffusion tensor imaging (DTI), perfusion imaging, FLAIR and contrast-enhanced 3D T1-weighted MR, were weekly performed on five untreated patients recently diagnosed with RR MS.
  
  
  RESULTS
  All five patients showed significant increases of the apparent diffusion coefficient (ADC) in the lesions compared to the first time point. One of the five patients presented 98 active lesions on ADC maps among which 36 had a volume larger than 10 mm(3). In two of these lesions, a 1 week transient decrease in ADC was detected at the time of the first gadolinium enhancement. Also, the perfusion analysis showed a concomitant increase in the relative cerebral blood volume.
  
  
  CONCLUSIONS
  The infrequency detection of such ADC decrease in a new lesion is probably due to its very short duration. This observation may be consistent with a hyper-acute inflammatory stage concomitant with an increased reactional perfusion.
authors: CREATIS - CNRS UMR 5220 & INSERM U1044, Université Claude Bernard-Lyon1 Villeurbanne, France ; Service de Neurologie A & EDMUS Coordinating Center for Multiple Sclerosis, Hôpital Neurologique Pierre Wertheimer Bron, France.
authors: Salem
authors: S
authors: Hannoun
authors: Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon Pierre-Bénite, France.
authors: Jean-Amédée
authors: JA
authors: Roch
authors: CREATIS - CNRS UMR 5220 & INSERM U1044, Université Claude Bernard-Lyon1 Villeurbanne, France ; Service de Neurologie A & EDMUS Coordinating Center for Multiple Sclerosis, Hôpital Neurologique Pierre Wertheimer Bron, France.
authors: Francoise
authors: F
authors: Durand-Dubief
authors: Service de Neurologie A & EDMUS Coordinating Center for Multiple Sclerosis, Hôpital Neurologique Pierre Wertheimer Bron, France.
authors: Sandra
authors: S
authors: Vukusic
authors: CREATIS - CNRS UMR 5220 & INSERM U1044, Université Claude Bernard-Lyon1 Villeurbanne, France ; CERMEP - Imagerie du Vivant, Groupement Hospitalier Est Bron, France.
authors: Dominique
authors: D
authors: Sappey-Marinier
authors: Center for Neurological Imaging, Brigham and Women's Hospital Boston, Massachusetts.
authors: Charles R G
authors: CR
authors: Guttmann
authors: CREATIS - CNRS UMR 5220 & INSERM U1044, Université Claude Bernard-Lyon1 Villeurbanne, France ; Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon Pierre-Bénite, France.
authors: Francois
authors: F
authors: Cotton
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier / Q000378:metabolism / Q000473:pathology; D001927:Brain Diseases / Q000378:metabolism / Q000473:pathology; D004058:Diffusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009103:Multiple Sclerosis / Q000378:metabolism / Q000473:pathology*; D011446:Prospective Studies
keywords: Apparent diffusion coefficient; diffusion tensor imaging; lesions; multiple sclerosis; perfusion; relative cerebral blood volume
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