Enhanced magnetic resonance imaging in multiple sclerosis

Abstract

Gadolinium-enhanced magnetic resonance imaging (MRI) is very sensitive in the detection of active lesions of multiple sclerosis (MS) and has become a valuable tool to monitor the evolution of the disease either natural or modified by treatment. In the past few years, several studies, on the one hand, have assessed several ways to increase the sensitivity of enhanced MRI to disease activity and, on the other, have investigated in vivo the nature and evolution of enhancing lesions using different non-conventional MR techniques to better define the relationship between enhancement and tissue loss in MS. The present review is a summary of these studies whose results are discussed in the context of MS clinical trial planning and monitoring.

Keywords

MS MRI Gd-enhancement treatment trials

Get full access to this article

View all access options for this article.

References

Grossman RI et al. (1986) Multiple sclerosis: Gadolinium enhancement in MR imaging . Radiology 161: 721-725 .

Hawkins CP et al. (1990) Duration and selectivity of blood brain barrier breakdown in chronic relapsing experimental allergic encephalomyelitis studied by gadolinium-DTPA and protein markers . Brain 113: 365-378 .

Brück W et al. (1997) Inflammatory central nervous system demyelination: correlation of magnetic resonance imaging findings with lesion pathology . Ann Neurol 42: 783-793 .

Lucchinetti CF , Bruck W , Rodriguez M , Lassmann H. (1996) Distinct patterns of multiple sclerosis indicates heterogeneity of pathogenesis . Brain Pathol 6: 259-261 .

Seeldrayers PA et al. (1993) Magnetic resonance imaging investigation of blood-brain barrier damage in adoptive transfer experimental autoimmune encephalomyelitis . J Neuroimmunol 46: 199-206 .

Namer IJ et al. (1994) Magnetic resonance imaging of antibody-mediated demyelinating experimental allergic encephalomyelitis . J Neuroimmunol 54: 41-50 .

Morrissey SP et al. (1996) In vivo MRI and its histological correlates in acute adoptive transfer experimental allergic encephalomyelitis. Quantification of inflammation and oedema . Brain 119: 239-248 .

Miller DH et al. (1988). Serial gadolinium-enhanced magnetic resonance imaging in multiple sclerosis . Brain 111: 927-939 .

Lai M et al. (1996) A preliminary study into the sensitivity of disease activity detection by serial weekly magnetic resonance imaging in multiple sclerosis . J Neurol Neurosurg Psychiatry 60: 339-341 .

10.

Tortorella C et al. (1999) Disease activity in multiple sclerosis studied with weekly triple dose magnetic resonance imaging . JNeurol 246: 689-692 .

11.

Kermode AG et al. (1990) Heterogeneity of blood-barrier changes in multiple sclerosis: an MRI study with gadolinium-DTPA enhancement . Neurology 40: 229-235 .

12.

Thompson AJ et al. (1990) Patterns of disease activity in multiple sclerosis: clinical and magnetic resonance imaging study . Br Med J 300: 631-634 .

13.

Harris JO et al. (1991) Serial Gadolinium-enhanced magnetic resonance imaging scans in patients with early, relapsing-remitting multiple sclerosis: implications for clinical trials and natural history . Ann Neurol 29: 548-555 .

14.

Smith ME et al. (1993) Clinical worsening in multiple sclerosis is associated with increased frequency and area of gadopentetate dimeglumine-enhancing magnetic resonance imaging lesions . Ann Neurol 33: 480-489 .

15.

Pozzilli C et al. (1996) Magnetic resonance imaging changes with recombinant human interferon beta-1a: a short term study in relapsing-remitting multiple sclerosis . J Neurol Neurosurg Psychiatry 61: 251-258 .

16.

Molyneux PD et al. (1998) Correlations between monthly enhanced MRI lesion rate and changes in T2 lesion volume in multiple sclerosis . Ann Neurol 43: 332-339 .

17.

Koudriavtseva T et al. (1997) Gadolinium enhanced MRI disease activity in relapsing-remitting multiple sclerosis . J Neurol Neurosurg Psychiatry 62: 285-287 .

18.

Kappos L et al. (1999) Predictive value of gadolinium-enhanced MRI for relapse rate and changes in disability/impairment in multiple sclerosis: a metaanalysis . Lancet 353: 964-969 .

19.

Simon JH et al. (1999) A longitudinal study of brain atrophy in relapsing multiple sclerosis . Neurology 53: 139-148 .

20.

Coles AJ et al. (1999) Monoclonal antibody treatment exposes three mechanisms underlying the clinical course of multiple sclerosis . Ann Neurol 46: 296-304 .

21.

Simon JH et al. (1998) Magnetic resonance studies of intramuscular interferon beta-1a for relapsing multiple sclerosis . Ann Neurol 43: 79-87 .

22.

Barkhof F et al. (1997) Comparison of MR imaging criteria at first presentation to predict conversion to clinically definite multiple sclerosis . Brain 120: 2059-2069 .

23.

Paty DW et al. (1988) Magnetic resonance imaging in the diagnosis of multiple sclerosis: a prospective study of comparison with clinical evaluation, evoked potential, oligoclonal banding, and CT . Neurology 38: 180-185 .

24.

Fazekas F et al. (1988) Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis . Neurology 38: 1822-1825 .

25.

Morrissey SP et al. (1993) The significance of brain magnetic resonance imaging abnormalities at presentation with clinically isolated syndromes suggestive of multiple sclerosis, A 5-year follow-up study . Brain 116: 135-146 .

26.

Filippi M et al. (1994) Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis . Neurology 44: 635-641 .

27.

O'Riordan JI et al. (1998) The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10- year follow-up . Brain 121: 495-503 .

28.

Sailer M et al. (1999) Quantitative MRI in patients with clinically isolated syndromes suggestive of demyelination . Neurology 52: 599-606 .

29.

Miller DH et al. (1996) Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis . Ann Neurol 39: 6-16 .

30.

Nauta JJP , Thompson AJ , Barkhof F , Miller DH. (1994) Magnetic resonance imaging in monitoring the treatment of multiple sclerosis patients: statistical power of parallel-groups and crossover designs . J Neurol Sci 122: 6-14 .

31.

Truyen L et al. (1997) Specific power calculations for magnetic resonance imaging (MRI) in monitoring active relapsing-remitting multiple sclerosis (MS): implications for phase II therapeutic trials . Mult Scler 2: 283-290 .

32.

Barkhof F et al. (1997) Strategies for optimizing MRI techniques aimed at monitoring disease activity in multiple sclerosis . JNeurol 244: 76-84 .

33.

Filippi M et al. (1998) Guidelines for using quantitative measures of brain magnetic resonance imaging abnormalities in monitoring the treatment of multiple sclerosis . Ann Neurol 43: 499-506 .

34.

Trubidy N et al. (1998) Exploratory treatment trials in multiple sclerosis using MRI: sample size calculations for relapsing remitting and secondary progressive subgroups using placebo controlled parallel groups . JNeurol Neurosurg Psychiatry 64: 50-55 .

35.

Sormani MP et al. (1999) Statistical power of MRI monitored trials in multiple sclerosis: new data and comparison with previous results . J Neurol Neurosurg Psychiatry 66: 465-469 .

36.

Barkhof F et al. (1997) Improving intraobserver variation in reporting gadolinium-enhanced MRI lesions in multiple sclerosis . Neurology 49: 1682-1688 .

37.

Filippi M et al. (1997) Inter-rater variability in reporting enhancing lesions on standard and triple dose gadolinium scans in patients with multiple sclerosis . Mult Scler 3: 226-230 .

38.

Miller DH et al. (1998) The role of magnetic resonance techniques in understanding and managing multiple sclerosis . Brain 121: 3-24 .

39.

Miller DH et al. (1999) Effect of interferon b-1b on magnetic resonance imaging outcomes in secondary progressive multiple sclerosis: Results of a european multicenter, randomized, double-blind, placebo-controlled trial . Ann Neurol 46: 850-859 .

40.

Thorpe JW et al. (1996) Serial gadolinium-enhanced MRI of the brain and spinal cord in early relapsing-remitting multiple sclerosis . Neurology 46: 373-378 .

41.

Filippi M et al. (1997) Sensitivity of delayed gadolinium-enhanced MRI in multiple sclerosis . Acta Neurol Scand 95: 331-334 .

42.

Silver NC et al. (1997) Sensitivity of contrast enhanced MRI in multiple sclerosis: effects of gadolinium dose, magnetization transfer contrast and delayed imaging . Brain 120: 1149-1161 .

43.

Filippi M et al. (1996) Comparison of triple dose versus standard dose gadolinium-DTPA for detection of MRI enhancing lesions in patients with MS . Neurology 46: 379-384 .

44.

Filippi M et al. (1998) A multi-centre longitudinal study comparing the sensitivity of monthly MRI after standard and triple dose gadolinium-DTPA for monitoring disease activity in multiple sclerosis: implications for clinical trials . Brain 121: 2011-2020 .

45.

Filippi M et al. (1996) A high-resolution three-dimensional gradient echo sequence improves the detection of disease activity in multiple sclerosis . Ann Neurol 40: 901-907 .

46.

van Waesberghe JHTM et al. (1997) Single dose gadolinium with magnetization transfer contrast versus triple dose gadolinium in detecting enhancing multiple sclerosis lesions . AJNR Am J Neuroradiol 18: 1279-1285 .

47.

Petrella JR et al. (1996) Multiple sclerosis lesions: relationship between MR enhancement pattern and magnetization transfer effect . AJNR Am J Neuroradiology 17: 1041-1049 .

48.

Hiehle JF et al. (1995) Magnetization transfer effect in MR-detected multiple sclerosis lesions: comparison with gadolinium-enhanced spin-echo images and non-enhanced T1- weighted images . AJNR Am J Neuroradiology 16: 69-77 .

49.

Metha RC , Pike BG , Enzmann DR. (1995) Improved detection of enhancing and non-enhancing lesions of multiple sclerosis with magnetization transfer . AJNR Am J Neuroradiology 16: 1771-1778 .

50.

Bastianello S et al. (1998) Sensitivity of enhanced MR in multiple sclerosis: effects of contrast doses and magnetization transfer contrast . AJNR Am J Neuroradiology 19: 1863-1867 .

51.

Filippi M et al. (1998) Quantitative assessment of magnetic resonance imaging lesion load in multiple sclerosis . J Neurol Neurosurg Psychiatry 64 (Suppl): 88-93 .

52.

Silver NC et al. (1999) Evidence of widespread subtle blood-brainbarrierdysfunctionassociatedwithprogressive MS [abstract] . Proc Intl Soc Magn Reson Med 7: 628-628 .

53.

Filippi M et al. (1999) Interferon b treatment for multiple sclerosis has a graduated effect on MRI enhancing lesions according to their size and pathology . J Neurol Neurosurg Psychiatry 67: 386-389 .

54.

Rovaris M , et al. (1999) Cumulative effect of a weekly low dose of interferon beta 1a on standard and triple dose contrast-enhanced MRI from multiple sclerosis patients . J Neurol Sci 171: 130-134 .

55.

Campi A et al. (1996) Magnetization transfer ratios of contrast-enhancing and non enhancing lesions in multiple sclerosis . Neuroradiology 38: 115-119 .

56.

Falini A et al. (1998) Benign versus secondary-progressive multiple sclerosis: the potential role of proton MR spectroscopy in defining the nature of disability . AJNR Am J Neuroradiology 19: 223-229 .

57.

Werring DJ et al. (1999) Diffusion tensor imaging of lesions and normal-appearing white matter in multiple sclerosis . Neurology 52: 1626-1632 .

58.

Filippi M et al. (2000) A quantitative study of water diffusion in MS lesions and NAWM using echo-planar imaging . Arch Neurol 57: 1017-1021 .

59.

Davie CA et al. (1994) Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions . Brain 117: 49-58 .

60.

van Waesberghe JH et al. (1998) Patterns of lesion development in multiple sclerosis: longitudinal observations with T1-weighted spin-echo and magnetization transfer MR . AJNR Am J Neuroadiol 19: 675-683 .

61.

Filippi M et al. (1998) Magnetization transfer changes in the normal appearing white matter precede the appearance of enhancing lesions in patients with multiple sclerosis . Ann Neurol 43: 809-814 .

62.

Goodkin DE et al. (1998) A serial study of new MS lesions and the white matter from which they arise . Neurology 51: 1689-1697 .

63.

Silver NC et al. (1998) Serial magnetization transfer imaging to characterize the early evolution of new MS lesions . Neurology 51: 758-764 .

64.

Filippi M et al. (1998) Magnetization transfer ratios in MS lesions enhancing after different doses of gadolinium . Neurology 50: 1289-1293 .

65.

Lai HM et al. (1997) Serial magnetisation transfer ratios in gadolinium-enhancing lesions in multiple sclerosis . J Neurol 244: 308-311 .

66.

Filippi M , Gomi G. (1997) Magnetization transfer ratio changes in a symptomatic lesion of a patient at presentation with possible multiple sclerosis . JNeurol Sci 151: 79-81 .

67.

Dousset V , Gayou A , Brochet B , Caille JM. (1998) Early structural changes in acute MS lesions assessed by serial magnetization transfer studies . Neurology 51: 1150-1155 .

68.

Rocca MA et al. (1999) Long term changes of MT-derived measures from patients with relapsing-remitting and secondary-progressive multiple sclerosis . AJNR Am J Neuroadiol 20: 821-827 .

69.

Filippi M et al. (1999) Short-term evolution of individual enhancing MS lesions studied with magnetization transfer imaging . Magn Reson Imaging 17: 979-984 .

70.

Filippi M , Rocca MA , Comi G. (1998) Magnetization transfer ratios of multiple sclerosis lesions with variable durations of enhancement . J Neurol Sci 159: 162-165 .

71.

Ge Y et al. (2000) Brain atrophy in relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis: longitudinal quantitative analysis . Radiology 214: 665-670 .

72.

van Walderveen MAA et al. (1999) Development of hypointense lesions on T1-weighted spin-echo magnetic resonance images in multiple sclerosis. Relation to inflammatory activity . Arch Neurol 56: 345-351 .

73.

Filippi M et al. (1998) A one year study of new lesions in multiple sclerosis using monthly gadolinium enhanced MRI: correlations with changes of T2 and magnetization transfer lesion loads . J Neurol Sci 158: 203-208 .

74.

Bitsch A et al. (2000) Acute axonal injury in multiple sclerosis: Correlation with demyelination and inflammation . Brain 123: 1174-1183 .

75.

Filippi M et al. (2000) The effect of cladribine on T1 `black hole' changes in progressive MS . J Neurol Sci 176: 42-44 .

76.

Paolillo A et al. (1999) Quantitative MRI in patients with secondary progressive MS treated with monoclonal antibody Campath 1H . Neurology 53: 751-757 .

77.

Barkhof F et al. (2000) Interferon beta-1b reduces development of T1 black holes on MRI in secondary progressive multiple sclerosis [abstract] . Neurology 54 (Suppl 3): A16-A16 .

78.

Pike GB et al. (1998) A longitudinal study of magnetization transfer in multiple sclerosis . Proc Int Soc Magn Reson Med 1: 122-122 .

79.

Narayana PA , Doyle TJ , Lai DJ , Wolinsky JS (1998) Serial proton magnetic resonance spectroscopic imaging, contrast-enhanced magnetic resonance imaging, and quantitative lesion volumetry in multiple sclerosis . Ann Neurol 43: 56-71 .

80.

Rocca MA , Cercignani M , Iannucci G , Filippi M. (2000) A weekly magnetization transfer and diffusion weighted imaging study of multiple sclerosis lesions and NAWM . Proc Intl Soc Magn Reson Med 2: 1192-1192 .

81.

Filippi M , Tortorella C , Bozzali M. (1999) Normal-appearing white matter changes in multiple sclerosis: the contribution of magnetic resonance techniques . Mult Scler 5: 273-282 .

82.

Sipe JC et al. (1999) Method for intracellular magnetic labeling of human mononuclear cells using approved iron contrast agents . Magn Reson Imaging 17: 1521-1523 .

83.

Dousset V et al. (1999) In vivo macrophage activity imaging in the central nervous system detected by magnetic resonance . Magn Reson Med 41: 329-333 .

84.

Lee MA , Smith S , Palace J , Matthews PM (1998) Defining multiple sclerosis disease activity using MRI T2- weighted difference imaging . Brain 121: 2095-2102 .

85.

Rovaris M , et al. (1999) Multiple sclerosis: interobserver agreement in reporting active lesions on serial brain MRI using conventional spin echo, fast spin echo, fast fluid-attenuated inversion recovery and post-contrast T1- weighted images . JNeurol 246: 920-925 .

86.

Horsfield MA , Rocca MA , Cercignani M , Filippi M (2000). Activity revealed in MRI of multiple sclerosis without contrast agent. A preliminary report . Magn Reson Imaging 18: 139-142 .