Barkhof F, Hommes O R, Scheltens P, Valk J
Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands.
Neurology. 1991 Aug;41(8):1219-22. doi: 10.1212/wnl.41.8.1219.
In 12 patients with definite multiple sclerosis who received a total of 21 courses of high-dose (1 gram daily for 10 consecutive days) intravenous methylprednisolone, we performed MRI of the brain with and without gadolinium-DTPA before and after treatment. On the initial MRI, there was a total of 98 enhancing lesions, 93 of which were also represented on the unenhanced images. After treatment, 13 patients improved clinically, and 78 of the lesions lost enhancement but remained visible on the unenhanced images. There were six new enhancing lesions on the second MRI. Thus, the blood-brain-barrier integrity improved after high-dose IV methylprednisolone, which correlated well with the clinical improvement. The lesions remaining visible on the unenhanced images indicate an incomplete histologic recovery at the time of the second scan, and also demonstrate that unenhanced MRI alone is not sufficient to monitor disease activity in the short term in multiple sclerosis.
在12例确诊为多发性硬化症的患者中，他们总共接受了21个疗程的大剂量（连续10天每天1克）静脉注射甲基泼尼松龙治疗，我们在治疗前后分别进行了有无钆喷酸葡胺增强的脑部MRI检查。在初始MRI上，共有98个强化病灶，其中93个在未增强图像上也有显示。治疗后，13例患者临床症状改善，78个病灶失去强化，但在未增强图像上仍可见。第二次MRI出现6个新的强化病灶。因此，大剂量静脉注射甲基泼尼松龙后血脑屏障完整性得到改善，这与临床改善情况密切相关。在未增强图像上仍可见的病灶表明在第二次扫描时组织学恢复不完全，同时也表明仅未增强MRI不足以在短期内监测多发性硬化症的疾病活动。
