Assessment of disease activity in multiple sclerosis phenotypes with combined gadolinium- and superparamagnetic iron oxide-enhanced MR imaging.
Radiology. 2012-07-01; 264(1): 225-233
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1. Radiology. 2012 Jul;264(1):225-33. doi: 10.1148/radiol.12111416.
Assessment of disease activity in multiple sclerosis phenotypes with combined
gadolinium- and superparamagnetic iron oxide-enhanced MR imaging.
Tourdias T(1), Roggerone S, Filippi M, Kanagaki M, Rovaris M, Miller DH, Petry
KG, Brochet B, Pruvo JP, Radüe EW, Dousset V.
(1)Department of Neuroradiology and INSERM U1049, CHU de Bordeaux, Université
Bordeaux Segalen, Bordeaux, France.
PURPOSE: To compare magnetic resonance (MR) imaging features of multiple
sclerosis (MS) lesions after the administration of a gadolinium-based contrast
agent and ultrasmall superparamagnetic iron oxide (USPIO) particles among the
clinical phenotypes of MS and over time.
MATERIALS AND METHODS: This study was approved by the local ethics committee, and
written informed consent was obtained from all patients. Twenty-four patients
with MS (10 with relapsing and 14 with progressive forms) underwent clinical and
gadolinium- and USPIO-enhanced MR examinations at baseline and 6-month follow-up.
The number of lesions that enhanced with gadolinium alone, USPIO alone, or both
was compared with the Pearson χ2 or Fisher exact test, and lesion sizes were
compared with the Wilcoxon Mann-Whitney U test. At 6-month follow-up, the lesion
signal intensity on precontrast T1-weighted images and the enhancement after
repeat injection of the contrast agent were compared with the baseline
postcontrast imaging features by using the McNemar test.
RESULTS: Fifty-six lesions were considered active owing to contrast enhancement
at baseline; 37 lesions (66%) in 10 patients enhanced with gadolinium. The use of
USPIO helped detect 19 additional lesions (34%), and two additional patients were
classified as having active disease. Thus, the use of both agents enabled
detection of 51% (19 of 37 lesions) more lesions than with gadolinium alone.
Enhanced lesions were more frequently observed in the relapsing compared with the
progressive forms of MS (P