Three Subsequent Single Doses of Gadolinium Chelate for Brain MR Imaging in Multiple Sclerosis
Francesco Sardanellia,
Andrea Iozzellib,
Caterina Losaccob,
Alessandra Murialdoc and
Massimo Filippid
a Department of Diagnostic Imaging, Istituto Policlinico San Donato, San Donato Milanese
b Departments of Diagnostic Imaging, University of Genoa, Genoa, Italy
c Neurological Sciences and Vision, University of Genoa, Genoa, Italy
d Neuroimaging Research Unit, Department of Neurosciences, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
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FIG 1. Para-axial T1-weighted spin-echo MR images.
A, Five minutes after the first intravenous administration of an SD (0.1 mmol/kg) of the paramagnetic contrast agent, no contrast enhancement attributable to a white matter lesions is visible.
B, Five minutes after the administration of a second SD of the paramagnetic contrast agent (for a total of 0.2 mmol/kg), no contrast enhancement attributable to a white matter lesion is detectable.
C, Five minutes after the administration of a third SD of the paramagnetic contrast agent (for a total of 0.3 mmol/kg), a small area of contrast enhancement is clearly visible in the right hemisphere (arrow).
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FIG 2. Para-axial T1-weighted spin-echo MR images.
A, Five minutes after the first intravenous administration of an SD (0.1 mmol/kg) of the paramagnetic contrast agent, two enhancing lesions are visible: one in the right and the other in the left hemisphere (arrows).
B, Five minutes after the administration of a second SD of the paramagnetic contrast agent (for a total of 0.2 mmol/kg), the enhancement in these two lesions is more conspicuous (arrows). A third area of focal contrast enhancement is barely detectable in the frontal left lobe (arrowhead).
C, Five minutes after the administration of a third SD of the paramagnetic contrast agent (for a total of 0.3 mmol/kg), the enhancement in all the three lesions becomes more conspicuous so that even the small enhancement in the frontal left lobe can be detected with higher confidence.
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FIG 3. Plot shows the progressive percentage increase in the total number of enhancing lesions (TNEL), the total enhancing area (TEA), and the mean CNR (CNR) with an SD (SD), fractionated DD (DD), and fractionated TD (TD) of the paramagnetic contrast agent in 10 patients with MS.
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