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Enhancing Magnetic Resonance Imaging Lesions and Cerebral Atrophy in Patients With Relapsing Multiple Sclerosis
T. P. Leist, PhD, MD;
M. I. Gobbini, MD;
J. A. Frank, MD;
H. F. McFarland, MD
Arch Neurol. 2001;58:57-60.
Objective To examine the relation between the frequency of enhancing magnetic
resonance imaging lesions and their characteristics of enhancement and atrophy
in patients with early relapsing multiple sclerosis.
Design Analysis of number of enhancing lesions, ventricular volumes and diameters,
and lesion characteristics on monthly magnetic resonance imaging scans during
natural history follow-up.
Setting A clinical research institution.
Patients Sixteen patients with confirmed early relapsing multiple sclerosis.
Main Outcome Measure Cerebral atrophy as measured by ventricular enlargement.
Results Numbers of enhancing lesions correlated well with an increase of ventricular
size. This correlation was strongest for patients with a high proportion of
concentric ring–enhancing lesions with central contrast pallor.
Conclusions Inflammatory events, especially those within lesions with associated
blood-brain barrier breakdown, affect the ensuing loss of brain parenchyma.
Patients with a high proportion of lesions with central contrast pallor, which
is likely associated with more extensive tissue damage, have a higher rate
of atrophic changes.
From the Neuroimmunology Branch, National Institute of Neurological
Disorders and Stroke (Drs Leist, Gobbini, and McFarland), and Laboratory of
Diagnostic Radiology Research, Clinical Center (Dr Frank), National Institutes
of Health, Bethesda, Md.
Corresponding author: T. P. Leist, PhD, MD, Neuroimmunology Branch,
National Institute of Neurological Disorders and Stroke, National Institutes
of Health, 9000 Rockville Pike, Bldg 10, Room 5B16, Bethesda, MD 20892.
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