MAGNETIC-RESONANCE IMAGING IN MULTIPLE-SCLEROSIS - RESULTS IN 32 CASES

  • 1 January 1985
    • journal article
    • research article
    • Vol. 6  (2) , 171-176
Abstract
A prospective clinical study was performed in 32 patients with multiple sclerosis (MS) to evaluate the sensitivity of lesion detection and accuracy of lesion localization by neurologic examination, delayed enhanced computed tomography (CT) with a double dose of contrast material and proton magnetic resonance (MR) imaging. After neurologic examination patients were classified by probability of MS (possible, 4 patients; probable, 3 patients; and definite, 25 patients) and by disease activity (acute, chronic with acute exacerbation, or chronic progressive). Subsequently they underwent delayed enhanced CT scanning and MR imaging with more than 1 spin-echo technique. In 5 of 7 patients with possible or probable MS, both MR imaging and delayed enhanced CT were negative. In 25 cases of definite MS, MR imaging detected pathology in 19 (76%) cases, while CT detected lesions in 15 (60%) of 25 cases. In acute lesions (acute or chronic with acute exacerbation), the 5 techniques were of similar sensitivity (delayed CT was positive in 65% and MR imaging in 60%), while in chronic progressive MS, MR imaging was superior in lesion detection (MR imaging positive in 75%; delayed CT in 25%). While most lesions (55%) were seen in corresponding locations in both studies, neither MR nor delayed CT correlated well with lesion localization by neurologic examination because a large number of asymptomatic lesions were imaged and many symptomatic lesions were undetected. MS plaques imaged by MR were manifested by prolongation of T2 and were of 2 varieties: focal, acute lesions (T2 136-260 ms at 0.14 T) and chronic, diffuse, predominantly periventricular lesions (120-231 ms T2 at 0.14 T, normal white matter T2 of 77-118 ms at 0.14 T). Because of these overlapping ranges, chronicity of MS lesions could not be determined by T2 values alone. MR was at least as sensitive as delayed CT in lesion detection and it was more sensitive in detecting chronic MS plaques. MR imaging is a viable alternative to double-dose delayed CT in the evaluation of patients with MS, particularly in patients in whom i.v. contrast agents are prohibited or unrevealing.

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