American Journal of Neuroradiology, Vol 16, Issue 1 69-77, Copyright © 1995 by American Society of Neuroradiology
ARTICLES |
Magnetization transfer effects in MR-detected multiple sclerosis lesions: comparison with gadolinium-enhanced spin-echo images and nonenhanced T1-weighted images
JF Hiehle Jr, RI Grossman, KN Ramer, F Gonzalez-Scarano and JA Cohen
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104-4283.
PURPOSE: To define the relationship between magnetization transfer and blood-brain-barrier breakdown in multiple sclerosis lesions using gadolinium enhancement as an index of the latter. METHODS: Two hundred twenty lesions (high-signal abnormalities on T2-weighted images) in 35 multiple sclerosis patients were studied with gadolinium-enhanced spin- echo imaging and magnetization transfer. Lesions were divided into groups having nodular or uniform enhancement, ring enhancement, or no enhancement after gadolinium administration. For 133 lesions, T1- weighted images without contrast enhancement were also analyzed. These lesions were categorized as isointense or hypointense based on their appearance on the unenhanced T1-weighted images. RESULTS: There was no difference between the magnetization transfer ratio (MTR) of lesions as a function of enhancement. MTR of hypointense lesions on unenhanced T1- weighted images was, however, lower than the MTR of isointense lesions. CONCLUSION: We speculate that diminished MTR may reflect diminished myelin content and that hypointensity on T1-weighted images corresponds to demyelination. Central regions of ring-enhancing lesions had a lower MTR than the periphery, suggesting that demyelination in multiple sclerosis lesions occurs centrifugally. In addition, the short- repetition-time pulse sequence seems useful in the evaluation of myelin loss in patients with multiple sclerosis.
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