Burnham J A, Wright R R, Dreisbach J, Murray R S
Colorado Neurological Institute, Denver.
Neurology. 1991 Sep;41(9):1349-54. doi: 10.1212/wnl.41.9.1349.
Gadolinium (Gd) enhancement of brain lesions by MRI is a marker of active blood-brain barrier damage secondary to an inflammatory process. We studied the effects of high-dose (1,000 mg/d) intravenous (IV) methylprednisolone (Mp) for 4 to 8 days on Gd-enhancing lesions in seven patients with acute demyelinating diseases and compared pretreatment brain MRIs with studies obtained 1 to 4 days after treatment. Five patients had complete suppression, and two had significant suppression of Gd enhancement following treatment. In addition, six of seven patients had Gd-enhancing lesions that explained their clinical signs; in five of six of these patients, suppression of the Gd-enhanced lesions temporally correlated with clinical improvement. Thus, short courses of high-dose IV Mp suppress Gd enhancement in acute demyelinating lesions, and this correlates with clinical improvement.
钆（Gd）增强的脑病变通过磁共振成像（MRI）是继发于炎症过程的血脑屏障活性损伤的标志物。我们研究了高剂量（1000毫克/天）静脉注射（IV）甲泼尼龙（Mp）4至8天对7例急性脱髓鞘疾病患者钆增强病变的影响，并将治疗前的脑部MRI与治疗后1至4天获得的研究结果进行了比较。5例患者的钆增强完全被抑制，2例患者治疗后钆增强明显被抑制。此外，7例患者中有6例的钆增强病变可以解释其临床症状；在这6例患者中的5例中，钆增强病变的抑制与临床改善在时间上相关。因此，短疗程的高剂量静脉注射甲泼尼龙可抑制急性脱髓鞘病变中的钆增强，且这与临床改善相关。
