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A follow-up study of very low field MRI findings and clinical course in multiple sclerosis
J Palo1, L Ketonen, J Wikström
1Department of Neurology, University of Helsinki, Finland.
Abstract:
Seventy-three consecutive patients with definite multiple sclerosis (MS) were examined with very low field (0.17 and 0.02 tesla) magnetic resonance imaging (MRI) of the brain. Fifty-seven patients were examined a second time after 6 months, 41 patients a third time after 1 year, and 25 patients a fourth time after 2 years. The initial finding was abnormal in 57/73 patients (78%). The number of lesions increased with age, duration of disease, and increasing disability. Plaques were more numerous in progressive than in remitting MS. Of the patients with abnormal MRI 65% had more than 3 lesions, and in 82% lesions were smaller than 2.5 cm in diameter. After follow-ups of 1 year and 2 years the size of MRI lesions remained unchanged in 55% and 64%, respectively. Unchanged plaque numbers were found in 72% and 60%. Unchanged MRI was most common among patients with remitting MS who were in a stable phase. Decrease in size and disappearance of plaques correlated well with clinical remissions. Increase in size was rare even during relapses. New plaques could appear during all phases of clinical course although they reflected better a relapse of remitting or progressive disease.
Insights
Very low field magnetic resonance imaging (MRI) revealed brain lesions in most multiple sclerosis (MS) patients. Lesion count and size changes correlated with disease progression and clinical status.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a chronic neurological disease characterized by demyelination and axonal damage.
- Magnetic resonance imaging (MRI) is crucial for diagnosing and monitoring MS, but very low field MRI's utility is less explored.
Purpose of the Study:
- To evaluate the diagnostic and prognostic value of very low field (0.17 and 0.02 tesla) brain MRI in patients with definite multiple sclerosis.
- To assess the evolution of MRI-detected lesions over time and their correlation with clinical disease course.
Main Methods:
- Seventy-three patients with definite MS underwent serial brain MRI at very low field strengths (0.17T and 0.02T).
- Follow-up examinations were conducted at 6 months, 1 year, and 2 years.
- MRI findings, including lesion number and size, were analyzed and correlated with patient age, disease duration, disability, and clinical course (remitting vs. progressive).
Main Results:
- Initial MRI revealed abnormalities in 78% of patients.
- The number of lesions increased with age, disease duration, and disability, and was higher in progressive MS.
- Lesion size remained stable in over 50% of patients at 1 and 2 years; plaque numbers were also largely stable.
- Decreased lesion size and plaque disappearance correlated with clinical remissions, while new plaques appeared during relapses and other disease phases.
Conclusions:
- Very low field MRI is effective in detecting brain lesions in multiple sclerosis.
- MRI lesion dynamics, including size and number changes, reflect disease activity and progression.
- Serial MRI monitoring can provide insights into disease course and response to treatment, even at very low field strengths.