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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Mar;60(3):339–341. doi: 10.1136/jnnp.60.3.339

A preliminary study into the sensitivity of disease activity detection by serial weekly magnetic resonance imaging in multiple sclerosis.

M Lai 1, T Hodgson 1, M Gawne-Cain 1, S Webb 1, D MacManus 1, W I McDonald 1, A J Thompson 1, D H Miller 1
PMCID: PMC1073863  PMID: 8609517

Abstract

Long TR and gadolinium enhanced spin echo brain MRI was performed weekly for three months in three patients with relapsing-remitting or secondary progressive multiple sclerosis. During the study, 38 new enhancing lesions were seen; 11 showed enhancement for less than four weeks, and two enhanced on only one scan. All 16 new lesions seen on long TR scans showed initial enhancement. When only every fourth (monthly) scan was analysed, a total of 33 new enhancing lesions were seen. Subject to confirmation in a larger cohort, the results suggest: (a) that blood brain barrier leakage is an invariable event in new lesion development in relapsing-remitting and secondary progressive multiple sclerosis; (b) the small increase in sensitivity of weekly scanning does not justify its use in preference to monthly scanning when monitoring treatments.

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Selected References

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  1. Barkhof F., Scheltens P., Frequin S. T., Nauta J. J., Tas M. W., Valk J., Hommes O. R. Relapsing-remitting multiple sclerosis: sequential enhanced MR imaging vs clinical findings in determining disease activity. AJR Am J Roentgenol. 1992 Nov;159(5):1041–1047. doi: 10.2214/ajr.159.5.1414773. [DOI] [PubMed] [Google Scholar]
  2. Barkhof F., Valk J., Hommes O. R., Scheltens P., Nauta J. J. Gadopentetate dimeglumine enhancement of multiple sclerosis lesions on long TR spin-echo images at 0.6 T. AJNR Am J Neuroradiol. 1992 Jul-Aug;13(4):1257–1259. [PMC free article] [PubMed] [Google Scholar]
  3. Bastianello S., Pozzilli C., Bernardi S., Bozzao L., Fantozzi L. M., Buttinelli C., Fieschi C. Serial study of gadolinium-DTPA MRI enhancement in multiple sclerosis. Neurology. 1990 Apr;40(4):591–595. doi: 10.1212/wnl.40.4.591. [DOI] [PubMed] [Google Scholar]
  4. Capra R., Marcianò N., Vignolo L. A., Chiesa A., Gasparotti R. Gadolinium-pentetic acid magnetic resonance imaging in patients with relapsing remitting multiple sclerosis. Arch Neurol. 1992 Jul;49(7):687–689. doi: 10.1001/archneur.1992.00530310029008. [DOI] [PubMed] [Google Scholar]
  5. Filippi M., Campi A., Martinelli V., Colombo B., Yousry T., Canal N., Scotti G., Comi G. Comparison of triple dose versus standard dose gadolinium-DTPA for detection of MRI enhancing lesions in patients with primary progressive multiple sclerosis. J Neurol Neurosurg Psychiatry. 1995 Nov;59(5):540–544. doi: 10.1136/jnnp.59.5.540. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Finelli D. A., Hurst G. C., Gullapali R. P., Bellon E. M. Improved contrast of enhancing brain lesions on postgadolinium, T1-weighted spin-echo images with use of magnetization transfer. Radiology. 1994 Feb;190(2):553–559. doi: 10.1148/radiology.190.2.8284415. [DOI] [PubMed] [Google Scholar]
  7. Isaac C., Li D. K., Genton M., Jardine C., Grochowski E., Palmer M., Kastrukoff L. F., Oger J., Paty D. W. Multiple sclerosis: a serial study using MRI in relapsing patients. Neurology. 1988 Oct;38(10):1511–1515. doi: 10.1212/wnl.38.10.1511. [DOI] [PubMed] [Google Scholar]
  8. Kermode A. G., Thompson A. J., Tofts P., MacManus D. G., Kendall B. E., Kingsley D. P., Moseley I. F., Rudge P., McDonald W. I. Breakdown of the blood-brain barrier precedes symptoms and other MRI signs of new lesions in multiple sclerosis. Pathogenetic and clinical implications. Brain. 1990 Oct;113(Pt 5):1477–1489. doi: 10.1093/brain/113.5.1477. [DOI] [PubMed] [Google Scholar]
  9. Khoury S. J., Guttmann C. R., Orav E. J., Hohol M. J., Ahn S. S., Hsu L., Kikinis R., Mackin G. A., Jolesz F. A., Weiner H. L. Longitudinal MRI in multiple sclerosis: correlation between disability and lesion burden. Neurology. 1994 Nov;44(11):2120–2124. doi: 10.1212/wnl.44.11.2120. [DOI] [PubMed] [Google Scholar]
  10. Kurtzke J. F. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983 Nov;33(11):1444–1452. doi: 10.1212/wnl.33.11.1444. [DOI] [PubMed] [Google Scholar]
  11. McFarland H. F., Frank J. A., Albert P. S., Smith M. E., Martin R., Harris J. O., Patronas N., Maloni H., McFarlin D. E. Using gadolinium-enhanced magnetic resonance imaging lesions to monitor disease activity in multiple sclerosis. Ann Neurol. 1992 Dec;32(6):758–766. doi: 10.1002/ana.410320609. [DOI] [PubMed] [Google Scholar]
  12. Miller D. H., Barkhof F., Nauta J. J. Gadolinium enhancement increases the sensitivity of MRI in detecting disease activity in multiple sclerosis. Brain. 1993 Oct;116(Pt 5):1077–1094. doi: 10.1093/brain/116.5.1077. [DOI] [PubMed] [Google Scholar]
  13. Poser C. M., Paty D. W., Scheinberg L., McDonald W. I., Davis F. A., Ebers G. C., Johnson K. P., Sibley W. A., Silberberg D. H., Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983 Mar;13(3):227–231. doi: 10.1002/ana.410130302. [DOI] [PubMed] [Google Scholar]
  14. Revesz T., Kidd D., Thompson A. J., Barnard R. O., McDonald W. I. A comparison of the pathology of primary and secondary progressive multiple sclerosis. Brain. 1994 Aug;117(Pt 4):759–765. doi: 10.1093/brain/117.4.759. [DOI] [PubMed] [Google Scholar]
  15. Rodriguez M., Scheithauer B. W., Forbes G., Kelly P. J. Oligodendrocyte injury is an early event in lesions of multiple sclerosis. Mayo Clin Proc. 1993 Jul;68(7):627–636. doi: 10.1016/s0025-6196(12)60597-7. [DOI] [PubMed] [Google Scholar]
  16. Thompson A. J., Kermode A. G., Wicks D., MacManus D. G., Kendall B. E., Kingsley D. P., McDonald W. I. Major differences in the dynamics of primary and secondary progressive multiple sclerosis. Ann Neurol. 1991 Jan;29(1):53–62. doi: 10.1002/ana.410290111. [DOI] [PubMed] [Google Scholar]
  17. Thompson A. J., Miller D., Youl B., MacManus D., Moore S., Kingsley D., Kendall B., Feinstein A., McDonald W. I. Serial gadolinium-enhanced MRI in relapsing/remitting multiple sclerosis of varying disease duration. Neurology. 1992 Jan;42(1):60–63. doi: 10.1212/wnl.42.1.60. [DOI] [PubMed] [Google Scholar]

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