SERIAL WHOLE-BRAIN MAGNETIZATION-TRANSFER IMAGING IN PATIENTS WITH RELAPSING-REMITTING MULTIPLE-SCLEROSIS AT BASE-LINE AND DURING TREATMENTWITH INTERFERON BETA-1B
Nd. Richert et al., SERIAL WHOLE-BRAIN MAGNETIZATION-TRANSFER IMAGING IN PATIENTS WITH RELAPSING-REMITTING MULTIPLE-SCLEROSIS AT BASE-LINE AND DURING TREATMENTWITH INTERFERON BETA-1B, American journal of neuroradiology, 19(9), 1998, pp. 1705-1713
Citations number
35
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Clinical Neurology","Radiology,Nuclear Medicine & Medical Imaging
BACKGROUND AND PURPOSE: To determine whether occult disease fluctuates
with macroscopic lesions during the natural history of multiple scler
osis (MS) and whether therapeutic interventions affect occult disease,
we performed serial monthly magnetization transfer (MT) imaging in pa
tients with relapsing-remitting MS in a crossover trial with interfero
n beta-1b. METHODS: Serial whole-brain magnetization transfer ratios (
MTRs) in eight patients with relapsing-remitting MS and in four contro
l subjects were plotted as normalized histograms, and MTR parameters w
ere compared with contrast-enhancing lesions and bulk white matter les
ion load. RESULTS: In patients with relapsing-remitting MS, the histog
raphic peak of 0.25 +/- 0.01 and the histographic mean of 0.21 +/- 0.0
1 were statistically lower than corresponding values in control subjec
ts, in whom the histographic peak was 0.27 +/- 0.01 and the histograph
ic mean was 0.23 +/- 0.01. When histograms (with MTRs ranging from 0.0
to 0.5) were analyzed by quartiles (quartile 1 to quartile 4) based o
n histographic area, voxels with low MTRs in quartile 1 (0 to 0.12) in
creased during the baseline period and corresponded to bulk white matt
er lesion load. Interferon beta-1b reduced enhancing lesions by 91% an
d mean bulk white matter lesion load by 15%, but had no effect on MTR
in this patient cohort. CONCLUSION: Occult disease in normal-appearing
white matter of patients with relapsing-remitting MS measured by MTR
parallels the waxing and waning pattern of enhancing lesions and bulk
white matter lesion load during the baseline period. MTR is not altere
d by interferon beta-1b, which raises the possibility of ongoing disea
se in normal-appearing white matter (not detected by conventional MR s
equences).