Multiple sclerosis in children: value of serial MR studies to monitor patients

A series of six children with clinical (4) and laboratory (2) evidence of multiple sclerosis is described. The mean age at onset was 12 years and the female-male ratio was 5:1. All patients had white matter abnormalities on initial MR scans. On follow-up MR studies, performed every 3 to 5 months, all children exhibited changing patterns of CNS signal abnormalities. In three cases, clinically silent brain lesions were detected. In four patients with an acute clinical attack, large lesions were present, demonstrating a lamellar structure on T1- and T2-weighted images. The lesions were seen best on long TR/short TE spin-echo sequences. Combined sagittal and axial series with EKG gating and flow-compensation technique were best for MR follow-up studies. Our results show that MR is useful for monitoring patients with multiple sclerosis.