Since all enhancing lesions were associated with new lesions on unenhanced imaging and progression was only evident in 24% of patients with relapsing-remitting multiple sclerosis (RRMS), it is reasonable to consider reserving contrast for only those patients with evidence of progression on non-contrast MR images. This according to a recent retrospective image-analysis study that aimed to determine whether contrast could be reserved for only those patients who show new MS lesions on follow-up examinations. Researchers retrospectively reviewed brain MRIs of 138 patients. To increase the sensitivity, they used a previously described computerized image-comparison software to evaluate the stability or progression of MS white matter lesions in non-contrast FLAIR sequences. They found:
- 33 scans showed an increase in white matter lesion burden.
- Among those 33 patients, 14 examinations also demonstrated enhancing new lesions.
- While a single example of enhancement of a pre-existing white matter lesion that appeared unchanged in size was found, that same examination showed an overall increase in lesion burden with enhancement of other, new lesions.
- Thus, all patients with enhancing lesions had evidence of progression on their non-contrast imaging.
Mattay RR, Davtyan K, Bilello M, Mamourian AC. Do all patients with multiple sclerosis benefit from the use of contrast on serial follow-up MR imaging? A retrospective analysis. [Published online ahead of print October 4, 2018]. Am J Neuroradiol. doi:10.3174/ajnr.A5828.
This Week's Must Reads
Stroke Care Comparison of Asian Americans and Whites, JAMA Neurology; ePub 2019 Jan 22; Song, Liang, et al
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Must Reads in Multiple Sclerosis
Prevalence of Asthma in Persons with MS, Mult Scler Relat Disord; ePub 2018 Dec 11; Hill, et al
Normal-Appearing White Matter in MS Examined, Neuroradiology; ePub 2018 Dec 12; Yu, et al
MS Disease Burden: Which Symptoms Matter Most?, Mult Scler Relat Disord; 2018 Oct; Barin, et al
Retinal Layer Thickness and MS Conversion Risk, Mult Scler; ePub 2018 Dec 3; Filippatou, et al
Importance of Coping and QOL in People with MS, Int J MS Care; ePub 2018 Dec 6; Grech, et al