American Journal of Neuroradiology, Vol 18, Issue 6 1041-1048, Copyright © 1997 by American Society of Neuroradiology
ARTICLES |
MR of the spinal cord in multiple sclerosis: relation to clinical subtype and disability
GJ Lycklama a Nijeholt, F Barkhof, P Scheltens, JA Castelijns, H Ader, JH van Waesberghe, C Polman, SJ Jongen and J Valk
Department of Radiology, Dutch MR Center for MS Research, Vrije Universiteit Hospital, Amsterdam, the Netherlands.
PURPOSE: To determine whether the MR appearance of the spinal cord in patients with multiple sclerosis (MS) differs according to clinical subtype. METHODS: The spinal cords of 20 healthy control subjects and 60 patients with MS (22 with relapsing-remitting disease, 22 with secondary-progressive disease, and 16 with primary-progressive disease) were examined with sagittal dual-echo spin-echo MR imaging and with axial T2*-weighted gradient-echo MR imaging. Two interpreters scored the images for focal lesions and for diffuse abnormalities. Cross- sectional areas of the cords were measured at the C-2 level. RESULTS: No abnormalities were found in any of the control subjects nor in two of the patients. Fifty (83%) of 60 patients had focal lesions. Diffuse abnormality and focal lesions were found in 50% of patients with secondary-progressive MS, in 25% of patients with primary-progressive disease, and in 18% of patients with relapsing-remitting disease. Diffuse abnormality without focal lesions was found in seven patients with primary-progressive MS and in one patient with secondary- progressive MS. Patients with diffuse abnormalities had a smaller cross- sectional area of the spinal cord and they suffered from more disability than did patients without diffuse abnormalities. CONCLUSION: The MR appearance of the spinal cord differs among clinical subgroups of MS. Diffuse abnormality of the spinal cord is associated with a progressive clinical course and greater disability.
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