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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-DPTA 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,78 of the lesions lost enhancement but remained visible on the unenhanced images.There were six new enhancing lesion 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. |
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gadolinium
MRI
MRI,abnormal
MRI,contrast enhanced
multiple sclerosis
steroid
steroid therapy,CNS treatment and complications with
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