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GADOLINIUM ENHANCEMENT INCREASES THE SENSITIVITY OF MRI IN DETECTING DISEASE-ACTIVITY IN MULTIPLE-SCLEROSIS

MILLER, DH; BARKHOF, F; NAUTA, JJP; (1993) GADOLINIUM ENHANCEMENT INCREASES THE SENSITIVITY OF MRI IN DETECTING DISEASE-ACTIVITY IN MULTIPLE-SCLEROSIS. BRAIN , 116 1077 - 1094.

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Abstract

There is now widespread agreement that serial brain MRI is useful in monitoring treatments designed to modify the course of multiple sclerosis. It has been less clear whether gadolinium enhancement is needed. We therefore compared the relative sensitivity of long repetition time (TR) spin echo (SE) and gadolinium enhanced short TR SE sequences in detecting active lesions. A blind analysis of the two sequences was performed in 26 untreated patients with early relapsing - remitting (19) or secondary progressive (seven) multiple sclerosis who underwent monthly MRI on four occasions (one baseline and three follow-up). Active lesions were defined as either new or enlarged lesions on long TR SE, or new or persistent enhancing lesions on short TR SE.In one patient there were 144 active lesions, all of which were seen with enhancement on short TR SE, but only 17 were seen on long TR SE. Amongst the remaining 25 cases, a total of 106 active lesions were seen: 68 (64%) were seen only with enhancement on short TR SE, 16 (15%) were seen only on long TR SE, while 22 (21%) were active on both sequences.We conclude that gadolinium enhancement markedly increases the sensitivity of monthly brain MRI in monitoring the treatment of relapsing - remitting or secondary progressive multiple sclerosis. With this frequency of scanning, a post contrast short TR SE sequence is the most sensitive method for detecting active lesions. The smaller yet still substantial incidence of active lesions seen only on the long TR SE sequence suggests that it should also be obtained.

Type: Article
Title: GADOLINIUM ENHANCEMENT INCREASES THE SENSITIVITY OF MRI IN DETECTING DISEASE-ACTIVITY IN MULTIPLE-SCLEROSIS
Keywords: EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS, CONCERTED ACTION GUIDELINES, HIGH-DOSE STEROIDS, RELAPSING PATIENTS, DTPA ENHANCEMENT, SERIAL, LESIONS, BRAIN, BREAKDOWN, DURATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: http://discovery.ucl.ac.uk/id/eprint/137206
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