Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Radiology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Acta Radiol. 2021 Jul;62(7):916-921. doi: 10.1177/0284185120946714. Epub 2020 Aug 6.
Magnetic resonance imaging (MRI) is widely used in patients with multiple sclerosis (MS) for different indications. However, frequent administration of gadolinium in these patients can have some potential complications. So, a more limited approach reducing the use of gadolinium should be considered.
To evaluate the additional benefits of contrast-enhanced MRI over non-contrast-enhanced MRI in routine follow-up of patients with MS.
This is a retrospective cohort study including patients with MS who underwent both contrast-enhanced and non-contrast-enhanced MRI for two time-points with an interval of at least six months. Non-contrast-enhanced images were compared for each patient and interpreted as non-progressive or progressive disease. Then, rate and type of enhancing lesions were analyzed and compared between the groups. All images were reviewed and compared visually by two radiologists.
A total of 462 patients (392 women; mean age = 36 years) were included. Of these patients, 352 were in the non-progressive group and 112 were in progressive group. Comparison of baseline and follow-up contrast-enhanced MRIs revealed that 13 (3.7%) patients in the non-progressive group and 58 (51.8%) patients in progressive group developed enhancing lesions ( < 0.001). All 58 patients in the progressive group developed new enhancing lesions, whereas all those in the non-progressive group revealed persistent or reactivated enhancing lesions without evidence of new lesions.
According to the very low incidence rate of new enhancing lesions in patients with non-progressive disease on follow-up non-contrast-enhanced MRI, routine administration of contrast in follow-up studies is not suggested.
磁共振成像（MRI）广泛应用于多发性硬化症（MS）患者的不同适应证。然而，在这些患者中频繁给予钆剂可能会产生一些潜在的并发症。因此，应考虑采用更有限的方法减少钆剂的使用。
评估增强 MRI 在 MS 患者常规随访中的额外获益。
这是一项回顾性队列研究，纳入了接受过至少两次增强和非增强 MRI 检查的 MS 患者，两次检查间隔至少 6 个月。对每位患者的非增强图像进行比较，并解读为疾病无进展或进展。然后，分析并比较两组的增强病变的发生率和类型。所有图像均由两位放射科医生进行回顾性和视觉比较。
共纳入 462 例患者（392 例女性；平均年龄 36 岁）。其中 352 例为非进展组，112 例为进展组。对比基线和随访的增强 MRI 发现，非进展组中有 13 例（3.7%）患者和进展组中有 58 例（51.8%）患者出现增强病变（ < 0.001）。进展组的所有 58 例患者均出现新的增强病变，而非进展组所有患者均显示持续或再激活的增强病变，无新病变的证据。
根据非增强 MRI 随访中非进展性疾病患者新出现增强病变的极低发生率，不建议在随访研究中常规给予增强剂。
