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Increased blood-brain barrier(BBB)permeability,important in the pathogenesis of MS,may be demonstrated as lesion enhancement with high- volume delayed CT(HVDCT).We studied 40 MS patients with history,neurologic examination,HVDCT,and MRI.In addition,7 of the patients with enhancing CT lesions were followed with serial MRI for up to 3 years and 7 months.In 3 of these patients we repeated the HVDCT.Patients with enhancing lesions on CT were younger,had shorter duration of disease,and had more frequent clinical relapses than did patients without enhancement.More than half (56%)of the enhancing CT lesions were in the deep white matter,23%were periventricular,and 21%were at the gray/white matter junction.Half the CT enhancing lesions,when followed by serial MRI,showed significant changes in lesion size.Although the majority(59%)of these lesions faded,some remained actively changing(25%)or became confluent with adjacent lesions (16%).In 48%of the MRI examinations that showed activity,some lesions were increasing in size while others were simultaneously decreasing in size. This study confirms that MS is a dynamic process in which recurrent episodes of BBB disruption and inflammation play a major role.Recurrent episodes of inflammation may well be a prelude to the largely irreversible changes of demyelination and gliosis. |
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CAT scan
CAT scan,abnormal
CAT scan,contrast enhanced
CAT scan,contrast enhanced,delayed
CAT scan,contrast enhanced,double dose
MRI
MRI,CAT scan compared to
multiple sclerosis
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