American Journal of Neuroradiology 20:1939-1945 (11 1999)
© 1999 American Society of Neuroradiology
ARTICLE
Evolution of Multiple Sclerosis Lesions on Serial Contrast-Enhanced T1-Weighted and Magnetization-Transfer MR Images
a From the Magnetic Resonance Unit, Department of Radiology (A.R., J.A., G.C., S.P.), and the Clinical Neuroimmunology Unit, Department of Neurology (C.N., M.T., J.R., X.M.), Vall d'Hebron University Hospital, Barcelona, Spain.
BACKGROUND AND PURPOSE: Magnetization-transfer imaging is a technique that could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions. The purpose of this work was to study the evolution of MS lesions on T1-weighted MR images over time and to investigate changes in magnetization-transfer ratio (MTR) values of MS lesions with different initial appearances on contrast-enhanced T1-weighted images.
METHODS: Eleven patients with relapsing-remitting MS were studied with MR imaging. The MTRs were calculated for 47 lesions that had been classified according to their appearance on contrast-enhanced T1-weighted images. Each patient was examined at four time points over a 1-year period. The MTR changes observed in the selected lesions were compared with their initial T1-weighted appearance.
RESULTS: The lowest MTR values were initially found in hypointense nonenhancing lesions and in ring-enhancing lesions, with both types showing a hypointense center. Changes in MTR values were more dynamic and reversible in ring-enhancing than in hypointense nonenhancing plaques. Nodular-enhancing lesions had slightly lower initial MTRs than did isointense nonenhancing lesions.
CONCLUSION: The absence or presence of contrast uptake may indicate a different pathologic basis for hypointense MS lesions on T1-weighted MR images. These differences should be kept in mind when considering T1 lesion load as a surrogate marker of disability in MS.
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