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NEUROLOGY 1990;40:591
© 1990 American Academy of Neurology

Serial study of gadolinium-DTPA MRI enhancement in multiple sclerosis

S. Bastianello, MD, PhD, C. Pozzilli, MD, PhD, S. Bernardi, MD, L. Bozzao, MD, L. M. Fantozzi, MD, C. Buttinelli, MD and C. Fieschi, MD

Department of Neurological Sciences, Neuroradiological Section (Drs. Bastianello, Bozzao, and Fantozzi), and 3rd Neurological Clinic (Drs. Pozzilli, Bernardi, Buttinelli, and Fieschi), University of Rome "La Sapienza", Italy.

We performed serial baseline and gadolinium (Gd)-DTPA-enhanced MRI in 4 patients with definite multiple sclerosis. Studies were performed every month for a total of 4 scans. We obtained short TR/short TE sequences at 10 and 60 minutes after Gd-DTPA injection. All patients had multiple hyperintense lesions seen on baseline MRI with long TR/short and long TE. There was Gd-DTPA enhancement in new, enlarging, and preexisting lesions that were unchanged in size. The enhancing lesions were always seen on T2-weighted images. There was no difference in enhancement between the 10- and 60-minute studies. Six of 85 preexisting lesions enhanced whereas all new or enlarging lesions enhanced. Enhancement persisted in only of the new or enlarging lesions, suggesting that MR enhancement is a transient phenomenon due to local temporary blood-brain barrier breakdown. Our data indicate that Gd-DTPA enhancement monitoring is more sensitive than unenhanced MRI for detecting disease activity in MS.

Address correspondence and reprint requests to Dr. Stefano Bastianello, Servizio Speciale di Neuroradiologia I, Dipartimento di Scienze Neurologiche, Université di Roma "La Sapienza," Viale dell'Université 30,00185 Rome, Italy.

Received May 30, 1989. Accepted for publication in final form September 27, 1989.




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