Kermode A G, Thompson A J, Tofts P, MacManus D G, Kendall B E, Kingsley D P, Moseley I F, Rudge P, McDonald W I
Multiple Sclerosis NMR Research Group, Institute of Neurology, London, UK.
Brain. 1990 Oct;113 ( Pt 5):1477-89. doi: 10.1093/brain/113.5.1477.
From an extensive serial magnetic resonance imaging (MRI) study in multiple sclerosis (MS) we have identified 4 cases in which disruption of the blood-brain barrier, as detected by gadolinium-DTPA enhancement, preceded other MRI abnormalities and in 1 case clinical evidence of the new lesion. This supports the view that a defect in the blood-brain barrier, and therefore inflammation, is an early and possibly crucial event in the pathogenesis of the new lesion in MS. These cases showed a marked discrepancy between MRI abnormality and symptoms. The mechanisms contributing to this disparity are discussed, and it is concluded that far from being surprising it is to be expected.
通过对多发性硬化症（MS）进行的一项广泛的系列磁共振成像（MRI）研究，我们发现了4例病例，其中钆-DTPA增强检测到的血脑屏障破坏先于其他MRI异常，还有1例出现了新病灶的临床证据。这支持了这样一种观点，即血脑屏障缺陷以及由此引发的炎症是MS新病灶发病机制中的早期且可能至关重要的事件。这些病例显示出MRI异常与症状之间存在明显差异。文中讨论了导致这种差异的机制，并得出结论，这远非令人惊讶之事，而是可以预料的。
