Fluid-Attenuated Inversion Recovery Signal Intensity as a Predictor of Gadolinium Enhancement in Relapsing-Remitting Multiple Sclerosis

Guranda, Mihail; Essig, Marco; Poulin, A.; Vosoughi, Reza

doi:10.7224/1537-2073.2016-053

Cited by 3 publications

(1 citation statement)

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“…While there have been a few other studies examining FLAIR signal characteristics of specific, individual lesions in patients with MS and their prediction of lesion enhancement, none of these studies examine our specific question regarding the relationship of enhancement based on each patient's change in the entire white matter lesion load. 39,40 On the basis of the results in our patient group reported here, enhancing lesions were found in 10% of the follow-up scans. This is well within the expected range for our patients based on clinical experience.…”

Section: Discussionmentioning

confidence: 52%

Do All Patients with Multiple Sclerosis Benefit from the Use of Contrast on Serial Follow-Up MR Imaging? A Retrospective Analysis

Mattay

Davtyan

Bilello

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Patients with multiple sclerosis routinely have MR imaging with contrast every 6-12 months to assess response to medication. Multiple recent studies provide evidence of tissue deposition of MR imaging contrast agents, questioning the long-term safety of these agents. The goal of this retrospective image-analysis study was to determine whether contrast could be reserved for only those patients who show new MS lesions on follow-up examinations. MATERIALS AND METHODS: We retrospectively reviewed brain MRIs of 138 patients. To increase our sensitivity, we used a previously described computerized image-comparison software to evaluate the stability or progression of multiple sclerosis white matter lesions in noncontrast FLAIR sequences. We correlated these findings with evidence of contrast-enhancing lesions on the enhanced T1 sequence from the same scan. RESULTS: Thirty-three scans showed an increase in white matter lesion burden. Among those 33 patients, 14 examinations also demonstrated enhancing new lesions. While we found a single example of enhancement of a pre-existing white matter lesion that appeared unchanged in size, that same examination showed an overall increase in lesion burden with enhancement of other, new lesions. Thus, we found that all patients with enhancing lesions had evidence of progression on their noncontrast imaging. CONCLUSIONS: Because all enhancing lesions were associated with new lesions on unenhanced imaging and progression was only evident in 24% of patients, in patients with relapsing-remitting MS, it is reasonable to consider reserving contrast for only those patients with evidence of progression on noncontrast MR images. ABBREVIATIONS: GBCA ϭ gadolinium-based contrast agents; RRMS ϭ relapsing-remitting MS

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Section: Discussionmentioning

confidence: 52%