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Serial gadolinium-DTPA of spinal cord MRI in multiple sclerosis: triple vs. single dose
I Yousry1, M Filippi, E Walther
1Departments of Neuroradiology and Neurology Klinikum Grosshadern, Ludwig-Maximilians Universität, Munich, Germany.
Abstract:
We compared the sensitivity of single and triple dose Gd-DTPA magnetic resonance imaging (MRI) in detecting enhancing lesions in the spinal cord (SC) from 15 patients with multiple sclerosis (MS). The patients were examined monthly on four occasions. We detected two enhancing lesions in two of 15 (13%) patients when a single dose of Gd-DTPA was used. No additional lesions were detected when a triple dose of Gd-DTPA was used. These results 1) confirm that enhanced spinal cord imaging does not significantly increase the detection of active lesions in MS, 2) they do not support the general application of triple dose Gd-DTPA when examining the SC but 3) suggest that further studies taking into account SC symptoms are necessary.
Insights
Single dose Gd-DTPA MRI is as effective as triple dose for detecting spinal cord lesions in multiple sclerosis (MS). Enhanced spinal cord imaging offers no significant advantage in identifying active MS lesions.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
- Spinal cord lesions are a key indicator of MS activity and progression.
- Magnetic resonance imaging (MRI) with gadolinium-based contrast agents (e.g., Gd-DTPA) is crucial for detecting active lesions.
Purpose of the Study:
- To compare the sensitivity of single versus triple doses of Gd-DTPA for detecting enhancing spinal cord lesions in MS patients.
- To evaluate the utility of enhanced spinal cord imaging in MS lesion detection.
Main Methods:
- A cohort of 15 patients with multiple sclerosis (MS) underwent spinal cord MRI examinations.
- Patients were assessed monthly over four occasions.
- Gd-DTPA contrast agent was administered in single and triple doses to assess lesion detection sensitivity.
Main Results:
- Only two enhancing lesions were detected in two out of 15 patients (13%) using a single dose of Gd-DTPA.
- No additional enhancing lesions were identified when a triple dose of Gd-DTPA was administered.
- Enhanced spinal cord imaging did not significantly increase the detection rate of active MS lesions.
Conclusions:
- Enhanced spinal cord imaging does not substantially improve the detection of active lesions in MS.
- The general use of triple-dose Gd-DTPA for spinal cord examination in MS is not supported by these findings.
- Further research incorporating spinal cord symptom data is warranted to better understand lesion detection in MS.