PT  - JOURNAL ARTICLE
AU  - S Bastianello
AU  - C Gasperini
AU  - A Paolillo
AU  - E Giugni
AU  - O Ciccarelli
AU  - M P Sormani
AU  - M A Horsfield
AU  - M Rovaris
AU  - C Pozzilli
AU  - M Filippi
TI  - Sensitivity of enhanced MR in multiple sclerosis: effects of contrast dose and magnetization transfer contrast.
DP  - 1998 Nov 01
TA  - American Journal of Neuroradiology
PG  - 1863--1867
VI  - 19
IP  - 10
4099  - http://www.ajnr.org/content/19/10/1863.short
4100  - http://www.ajnr.org/content/19/10/1863.full
SO  - Am. J. Neuroradiol.1998 Nov 01; 19
AB  - BACKGROUND AND PURPOSES New strategies have been developed to improve the sensitivity of contrast-enhanced MR imaging in quantifying disease activity in patients with multiple sclerosis (MS). The goal of the present study was to evaluate the sensitivity of T1-weighted images after injection of a triple dose of contrast material and application of a magnetization transfer (MT) pulse in the detection of enhancing lesions as compared with the conventional approach.METHODS Monthly MR images were obtained in 13 patients with relapsing-remitting MS for a period of 3 months. The MR studies were performed on two separate occasions with single- and triple-dose contrast material. In each session, T1- and T2-weighted spin-echo images with and without the MT pulse were obtained before and after contrast administration. All images were evaluated in a blinded fashion and scored in random order and consensually by two readers. The number of total and new enhancing lesions and active images was counted.RESULTS Eighty-six percent more enhancing lesions and 54% more new enhancing lesions were detected with triple-dose as compared with single-dose non-MT sequences, whereas single-dose MT images depicted 33% more enhancing lesions and 18% more new enhancing lesions than the single-dose non-MT images. Twenty-nine percent more lesions were detected on triple-dose non-MT images than on single-dose MT images. The combination of a triple dose of contrast material and MT did not produce any significant change in detection of enhancing lesions as compared with a triple dose of contrast without MT.CONCLUSION The use of a triple dose of contrast material is the best approach to maximize the sensitivity of enhanced MR imaging.