Our Experience with MRI Monitoring of Multiple Sclerosis Patients in Clinical Practice

Česká verzia

Authors: M. Vaněčková ¹; Z. Seidl ^1,2; J. Krásenský ¹; D. Horáková ³; E. Havrdová ³; J. Němcová ²; J. Daneš ¹
Authors place of work: Oddělení MR, Radiodiagnostická klinika 1. LF UK a VFN v Praze ¹; Vysoká škola zdravotnická, Praha ²; Neurologická klinika 1. LF UK a VFN v Praze ³
Published in the journal: Cesk Slov Neurol N 2010; 73/106(6): 716-720
Category: Short Communication

Summary

Objectives:
To document our monitoring of multiple sclerosis (MS) patients with magnetic resonance imaging (MRI) as routine practice and to demonstrate an optimal MRI monitoring protocol that meets the requirements of imaging pathological processes in MS, on standard equipment and in a short acquisition time. Patients and methods: We inspected 1,138 patients with clinically definite MS and patients with clinically isolated syndrome. The MRI consisted of measurement of the lesion load with FLAIR (fluid attenuated inversion recovery) and measurement of brain atrophy (as a baseline, brain parenchymal fraction was determined; percentage brain reduction per year was measured in the controls). A total of 737 patients who had participated in no previous study was monitored, as well as 181 patients within 5 years of the ASA study and 220 patients who had been monitored for the first symptom of CIS in the SET study. Results: At baseline, the lesion load (LL) median was 1.68 cm³, median BPF was 85.62%, and median EDSS (expanded disability status scale) scored 2. Results: After the first year: (n = 271), median LL was 1.77 cm³, brain reduction –0.14; EDSS = 2. After the second year median LL was 1.86, brain reduction –0.20 and EDSS = 2. Conclusions: The MRI procedure chosen for this work (measurement of lesion load and atrophy) appears to be an optimal protocol for monitoring inflammatory and degenerative changes in MS in the course of routine inspection. It is based on conventional MRI, it is simple, reproducible, short and employs fully automatated software, and is therefore suitable for everyday practice.

Key words:
multiple sclerosis – magnetic resonance imaging – monitoring – lesion load – atrophy measurement

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