Bastianello S, Gasperini C, Paolillo A, Giugni E, Ciccarelli O, Sormani M P, Horsfield M A, Rovaris M, Pozzilli C, Filippi M
Department of Neurological Sciences, University La Sapienza Rome, Italy.
AJNR Am J Neuroradiol. 1998 Nov-Dec;19(10):1863-7.
New strategies have been developed to improve the sensitivity of contrast-enhanced MR imaging in quantifying disease activity in patients with multiple sclerosis (MS). The goal of the present study was to evaluate the sensitivity of T1-weighted images after injection of a triple dose of contrast material and application of a magnetization transfer (MT) pulse in the detection of enhancing lesions as compared with the conventional approach.
Monthly MR images were obtained in 13 patients with relapsing-remitting MS for a period of 3 months. The MR studies were performed on two separate occasions with single- and triple-dose contrast material. In each session, T1- and T2-weighted spin-echo images with and without the MT pulse were obtained before and after contrast administration. All images were evaluated in a blinded fashion and scored in random order and consensually by two readers. The number of total and new enhancing lesions and active images was counted.
Eighty-six percent more enhancing lesions and 54% more new enhancing lesions were detected with triple-dose as compared with single-dose non-MT sequences, whereas single-dose MT images depicted 33% more enhancing lesions and 18% more new enhancing lesions than the single-dose non-MT images. Twenty-nine percent more lesions were detected on triple-dose non-MT images than on single-dose MT images. The combination of a triple dose of contrast material and MT did not produce any significant change in detection of enhancing lesions as compared with a triple dose of contrast without MT.
The use of a triple dose of contrast material is the best approach to maximize the sensitivity of enhanced MR imaging.
已开发出新策略以提高对比增强磁共振成像在量化多发性硬化症（MS）患者疾病活动度方面的敏感性。本研究的目的是评估与传统方法相比，注射三倍剂量对比剂并应用磁化传递（MT）脉冲后T1加权图像在检测强化病灶方面的敏感性。
对13例复发缓解型MS患者每月进行一次磁共振成像检查，为期3个月。磁共振研究在两个不同时间分别使用单剂量和三倍剂量对比剂进行。在每个检查阶段，在注射对比剂前后分别获取有和没有MT脉冲的T1加权和T2加权自旋回波图像。所有图像均由两名阅片者以盲法进行评估，按随机顺序评分并达成共识。统计总的和新出现的强化病灶数量以及有活性的图像数量。
与单剂量非MT序列相比，三倍剂量时检测到的强化病灶多86%，新出现的强化病灶多54%，而单剂量MT图像显示的强化病灶比单剂量非MT图像多33%，新出现的强化病灶多18%。三倍剂量非MT图像上检测到的病灶比单剂量MT图像多29%。与不使用MT的三倍剂量对比剂相比，三倍剂量对比剂与MT联合使用在检测强化病灶方面未产生任何显著变化。
使用三倍剂量对比剂是使增强磁共振成像敏感性最大化的最佳方法。
