scholarly journals Diagnostic value of gadolinium contrast administration for spinal cord magnetic resonance imaging in multiple sclerosis patients and correlative markers of lesion enhancement

2021 ◽  
Vol 7 (4) ◽  
pp. 205521732110479
Author(s):  
Kianush Karimian-Jazi ◽  
Ulf Neuberger ◽  
Katharina Schregel ◽  
Gianluca Brugnara ◽  
Martin Bendszus ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Gadolinium Contrast ◽  
Contrast Administration ◽  
Signal Ratio ◽  
Spine Magnetic Resonance Imaging

Background Magnetic resonance imaging is essential for monitoring people with multiple sclerosis, but the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging is unclear. Objective To assess the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging follow-up examinations and identify imaging markers correlating with lesion enhancement. Methods A total of 65 multiple sclerosis patients with at least 2 spinal magnetic resonance imaging follow-up examinations were included. Spine magnetic resonance imaging was performed at 3 Tesla with a standardized protocol (sagittal and axial T2-weighted turbo spin echo and T1-weighted post-contrast sequences). T2 lesion load and enhancing lesions were assessed by two independent neuroradiologists for lesion size, localization, and T2 signal ratio (T2 signallesion/T2 signalnormal appearing spinal cord). Results A total of 68 new spinal T2 lesions and 20 new contrast-enhancing lesions developed during follow-up. All enhancing lesions had a discernable correlate as a new T2 lesion. Lesion enhancement correlated with a higher T2 signal ratio compared to non-enhancing lesions (T2 signal ratio: 2.0 ± 0.4 vs. 1.4 ± 0.2, **** p < 0.001). Receiver operating characteristics analysis showed an optimal cutoff value of signal ratio 1.78 to predict lesion enhancement (82% sensitivity and 97% specificity). Conclusion Gadolinium contrast administration is dispensable in follow-up spine magnetic resonance imaging if no new T2 lesions are present. Probability of enhancement correlates with the T2 signal ratio.

Combining clinical and magnetic resonance imaging markers enhances prediction of 12-year disability in multiple sclerosis

2016 ◽  
Vol 23 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Tomas Uher ◽  
Manuela Vaneckova ◽  
Lukas Sobisek ◽  
Michaela Tyblova ◽  
Zdenek Seidl ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Cumulative Risk ◽  
Resonance Imaging ◽  
Cox Models ◽  
T2 Lesions ◽  
Therapeutic Decisions ◽  
The Individual

Background: Disease progression and treatment efficacy vary among individuals with multiple sclerosis. Reliable predictors of individual disease outcomes are lacking. Objective: To examine the accuracy of the early prediction of 12-year disability outcomes using clinical and magnetic resonance imaging (MRI) parameters. Methods: A total of 177 patients from the original Avonex-Steroids-Azathioprine study were included. Participants underwent 3-month clinical follow-ups. Cox models were used to model the associations between clinical and MRI markers at baseline or after 12 months with sustained disability progression (SDP) over the 12-year observation period. Results: At baseline, T2 lesion number, T1 and T2 lesion volumes, corpus callosum (CC), and thalamic fraction were the best predictors of SDP (hazard ratio (HR) = 1.7–4.6; p ⩽ 0.001–0.012). At 12 months, Expanded Disability Status Scale (EDSS) and its change, number of new or enlarging T2 lesions, and CC volume % change were the best predictors of SDP over the follow-up (HR = 1.7–3.5; p ⩽  0.001–0.017). A composite score was generated from a subset of the best predictors of SDP. Scores of ⩾4 had greater specificity (90%–100%) and were associated with greater cumulative risk of SDP (HR = 3.2–21.6; p < 0.001) compared to the individual predictors. Conclusion: The combination of established MRI and clinical indices with MRI volumetric predictors improves the prediction of SDP over long-term follow-up and may provide valuable information for therapeutic decisions.

scholarly journals Brain atrophy and employment in multiple sclerosis patients: a 10-year follow-up study

2020 ◽  
Vol 6 (1) ◽  
pp. 205521732090248
Author(s):  
Cecilie Jacobsen ◽  
Robert Zivadinov ◽  
Kjell-Morten Myhr ◽  
Turi O Dalaker ◽  
Ingvild Dalen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Grey Matter ◽  
Resonance Imaging ◽  
Cortical Volume ◽  
Deep Grey Matter ◽  
Multiple Sclerosis Patients ◽  
The Unemployed

Background Multiple sclerosis is often associated with unemployment. The contribution of grey matter atrophy to unemployment is unclear. Objectives To identify magnetic resonance imaging biomarkers of grey matter and clinical symptoms associated with unemployment in multiple sclerosis patients. Methods Demographic, clinical data and 1.5 T magnetic resonance imaging scans were collected in 81 patients at the time of inclusion and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. Statistical analysis was performed using a mixed linear model. Results At baseline 31 (38%) of the patients were unemployed, at 5-year follow-up 44 (59%) and at 10-year follow-up 34 (81%) were unemployed. The unemployed patients had significantly lower subcortical deep grey matter volume ( P < 0.001), specifically thalamus, pallidus, putamen and hippocampal volumes, and cortical volume ( P = 0.011); and significantly greater T1 ( P < 0.001)/T2 ( P < 0.001) lesion volume than the employed patient group at baseline. Subcortical deep grey matter volumes, and to a lesser degree cortical volume, were significantly associated with unemployment throughout the follow-up. Conclusion We found significantly greater atrophy of subcortical deep grey matter and cortical volume at baseline and during follow-up in the unemployed patient group. Atrophy of subcortical deep grey matter showed a stronger association to unemployment than atrophy of cortical volume during the follow-up.

Neuropsychological assessment in multiple sclerosis: a follow-up study with magnetic resonance imaging

1991 ◽  
Vol 238 (7) ◽  
pp. 395-400 ◽  
Author(s):  
C. Mariani ◽  
E. Farina ◽  
S. F. Cappa ◽  
G. P. Anzola ◽  
L. Faglia ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Neuropsychological Assessment ◽  
Resonance Imaging ◽  
Follow Up Study

Secondary paroxysmal dyskinesia in multiple sclerosis: Clinical–radiological features and treatment. Case report of seven patients

2017 ◽  
Vol 23 (13) ◽  
pp. 1791-1795 ◽  
Author(s):  
Ethel Ciampi ◽  
Reinaldo Uribe-San-Martín ◽  
Jaime Godoy-Santín ◽  
Juan Pablo Cruz ◽  
Claudia Cárcamo-Rodríguez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Case Report ◽  
Magnetic Resonance ◽  
Adverse Reactions ◽  
Resonance Imaging ◽  
Radiological Features ◽  
Cerebellar Peduncles ◽  
Magnetic Resonance Imaging Mri

Secondary paroxysmal dyskinesias (SPDs) are short, episodic, and recurrent movement disorders, classically related to multiple sclerosis (MS). Carbamazepine is effective, but with risk of adverse reactions. We identified 7 patients with SPD among 457 MS patients (1.53%). SPD occurred in face ( n = 1), leg ( n = 2), or arm +leg ( n = 4) several times during the day. Magnetic resonance imaging (MRI) showed new or enhancing lesions in thalamus ( n = 1), mesencephalic tegmentum ( n = 1), and cerebellar peduncles ( n = 5). Patients were treated with clonazepam and then acetazolamide ( n = 1), acetazolamide ( n = 5), or levetiracetam ( n = 1) with response within hours (acetazolamide) to days (levetiracetam). No recurrences or adverse events were reported after a median follow-up of 33 months.

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