It makes the initial diagnosis more reliable ( 4– 6) and provides an objective parameter of the evolution of the disease ( 2, 7– 9). In fact, contrast enhancement is considered an excellent marker of the inflammatory activity taking place in MS lesions. The use of intravenously administered paramagnetic contrast agent in the MR imaging of multiple sclerosis (MS) is clearly established in clinical practice and in research trials ( 1– 4). This approach allows the distinction of three levels of enhancement, and it reduces the amount of contrast agent needed to distinguish patients with active MS from those with nonactive MS. In defining active disease in these nine patients, we needed only 19 SDs versus the 30 SDs that would have been needed if individual TD injections were used.ĬONCLUSION: With three subsequent SD injections, the number of enhancing lesions progressively increases. Proportions of patients with at least one enhancing lesion were, for SD, four of 10 DD, seven of 10 and TD, nine of 10. Six lesions (27%) enhanced with all the three doses seven (32%), with both DD and TD and nine (41%), with only TD. Differences between SD and TD and between DD and TD were significant ( P <. RESULTS: In all patients, SD images showed six enhancing lesions double-dose (DD) images, 13 and TD images, 22. METHODS: In 10 patients, T1-weighted spin-echo images were acquired before and after three intravenous administrations of 0.1 mmol/kg of gadodiamide. Our aim was to determine whether the use of three subsequent single doses (SD) of a gadolinium chelate in brain MR imaging is useful in detecting MS lesions with different patterns of enhancement. However, individual TD injections do not provide data on the severity of the pathologic process in a population of lesions, and its clinical use is limited by the cost-benefit considerations. BACKGROUND AND PURPOSE: A triple-dose (TD) of gadolinium chelate is highly sensitive approach for detecting lesion activity in multiple sclerosis (MS).
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