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Magnetization transfer changes in the normal appering white matter precede the appearance of enhancing lesions in patients with multiple sclerosis
Author(s) -
Filippi Massimo,
Rocca Maria A.,
Martino Gianvito,
Horsfield Mark A.,
Comi Giancarlo
Publication year - 1998
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410430616
Subject(s) - multiple sclerosis , white matter , magnetization transfer , lesion , medicine , nuclear medicine , magnetic resonance imaging , radiology , pathology , psychiatry
Serial monthly magenetization transfer (MT) imaging was performed to evaluate whether a change of the normal appearing white matter (NAWM), which precedes the appearance of enhancing lesions, is seen in patients with multiple sclerosis (MS). Every 4 weeks for 3 months, 10 patients with relapsing‐remitting MS were scanned with a T1‐weighted sequence, 20 minutes after injection with 0.3 mmol/kg gadolinium‐DTPA (Gd‐DTPA). During each of the monthy sessions, MT and dual dual echo scans were also performed before Gd‐DTPA injection. On coregistered images, the same slices but outside any present or future MR abnormality, and in enhancing lesions at the time of their apperance. Forty‐eight new enhancing lesions with no corressponding abnormalities, the mean MTR in NAWM, measured from areas corresponding to future enhancing lesions, was significantly lower than the mean MTR in NAWM outside enhancing areas; the MTR decreased steadily as the time when the enhanced lesion approached. These results suggest that changes in the NAWM of patients with MS occur before lesions becomes evident on conventional MRI scans.