Multiple sclerosis: serial study of gadolinium-enhanced MR imaging.

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a chronic neurological disease.
• Assessing MS lesion activity is crucial for disease management.
• Magnetic resonance (MR) imaging is a key tool in MS diagnosis and monitoring.

Purpose of the Study:

• To evaluate the sensitivity of MR imaging enhancement for detecting active multiple sclerosis (MS) lesions.
• To compare MR imaging findings with clinical activity in patients with MS.
• To characterize the dynamic changes of MS lesions over time using serial MR imaging.

Main Methods:

• Retrospective analysis of MR imaging scans from 13 patients with definite MS.
• Utilized MR imaging with and without gadolinium diethylenetriaminepentaacetic acid (DTPA) dimeglumine enhancement.
• Compared MR imaging findings with clinical activity recorded within 4 weeks of the study.

Main Results:

• Gadolinium enhancement on MR imaging was highly sensitive (13/14 cases) for detecting active MS disease, outperforming clinical examination.
• The 3-minute postinjection, short repetition time (TR) image was most efficient for visualizing enhancement.
• Enhancing lesions (active plaques) originated from previously hyper- or isointense regions on long TR images.
• Previously active lesions became iso- or hyperintense on long TR images over time.
• Serial MR imaging revealed dynamic changes in lesion intensity, with some decreasing and others increasing.

Conclusions:

• MR imaging enhancement is a more sensitive marker of active MS disease than clinical assessment.
• MS lesions exhibit dynamic changes, including transient inflammation, edema, and potential remyelination.
• Longitudinal MR imaging studies are essential for understanding the evolving nature of MS lesions.