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Division of Neurology, Department of Medicine (Dr. Isaac, Mr. Grochowski, Mr. Palmer, and Drs. Kastrukoff, Oger, and Paty), and the Department of Diagnostic Radiology, Imaging Research Centre (Dr. Li, Ms. Genton, and Ms. Jardine), Health Sciences Centre Hospital, University of British Columbia, Vancouver BC, Canada.
Prospective monthly magnetic resonance imaging (MRI) studies were done over 6 months in seven relapsing MS patients. MRI and neurologic evaluations were compared for sensitivity in detecting disease activity. Four patients were clinically stable throughout the study. Three patients had five clinical relapses, two localized to the spinal cord and three to the brainstem. Eighteen new and ten enlarging MRI lesions were seen in five patients. Most lesions were less than 10 mm in diameter. All were clinically silent. Two patients developed major enlarging MRI lesions (seen in three slices) which increased in size over 2 months and then gradually became smaller over 2 months, leaving behind small residual areas of abnormality. There were 36 follow-up scans, 17 of which (47%) showed evidence for increasing activity. Thirteen (36%) of the scans had new lesions, most of them being small. This study shows that MRI evidence for disease activity in MS is much more frequent than is clinical evidence.
Address correspondence and reprint requests to Dr. Paty, Division of Neurology, Vancouver General Hospital, 222–2775 Heather Street, Vancouver, BC V5Z 3J3, Canada.
Supported by grants from the British Columbia Health Care Research Foundation, the Medical Research Council of Canada, and the Jacob W. Cohen Fund for Research into Multiple Sclerosis.
Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.
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