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Evaluation of plaque detection and optimum time of enhancement in acute attack multiple sclerosis after contrast
Hassan Hashemi1, Somayeh Behzadi, Hossein Ghanaati
1Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
Background:
Magnetic resonance imaging (MRI) is important in the early diagnosis of novel or relapsing multiple sclerosis (MS). In addition, the optimal MRI protocol plays an important role in detecting MS plaques.
Purpose:
To find the best time to detect MS plaques on MRI after Gadobutrol injection.
Material And Methods:
Sixty-two relapsing-remitting type MS patients, (56 women, 6 men) with the mean age of 31 ± 7 years were enrolled into this study. The patients underwent T1-weighted MRI scan without contrast agents. Subsequently, Gadobutrol was injected (0.1 mmol/kg) and MRI scanning was repeated after 30 s, 5, 10, 15, and 30 min of Gadobutrol injection. The size, signal intensity, and enhancement pattern were determined for each plaque by contrast-enhanced T1-weighted images.
Results:
Enhancing plaques were seen in 42 out of 62 patients. The mean number of enhancing plaques was 4 ± 8 plaques after 30 s of contrast injection. This figure increased to 7 ± 13 plaques after 15 min and 6 ± 10 plaques after 30 min. The signal intensity and size of plaques increased progressively, and the maximum signal intensity and plaque size were seen after 30 min (P < 0.001).
Conclusion:
The maximum number of enhancing plaques in MS patients was detected 15 min after contrast agent administration and the size and signal intensity of the lesions also increased remarkably at this time.
Insights
The optimal time to detect multiple sclerosis (MS) plaques using MRI after Gadobutrol injection is 15 minutes. This timing maximizes the detection of enhancing MS lesions, improving diagnostic accuracy.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Magnetic resonance imaging (MRI) is crucial for diagnosing multiple sclerosis (MS).
- Optimizing MRI protocols enhances the detection of MS plaques.
Purpose of the Study:
- To determine the optimal time for detecting MS plaques after Gadobutrol contrast injection.
- To enhance the diagnostic yield of MRI in multiple sclerosis.
Main Methods:
- Sixty-two patients with relapsing-remitting MS underwent T1-weighted MRI scans.
- Gadobutrol contrast was administered, with scans repeated at 30 seconds, 5, 10, 15, and 30 minutes.
- Plaque size, signal intensity, and enhancement patterns were analyzed.
Main Results:
- Enhancing plaques were identified in 42 out of 62 patients.
- The number of enhancing plaques peaked at 15 minutes post-injection (mean 7±13).
- Plaque size and signal intensity progressively increased, reaching maximums at 30 minutes.
Conclusions:
- The maximum number of enhancing MS plaques is detected 15 minutes after Gadobutrol administration.
- Plaque size and signal intensity also significantly increase by the 15-minute mark.
- This finding aids in optimizing MRI protocols for MS diagnosis.
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