Correlation between magnetic resonance imaging findings and lesion development in chronic, active multiple sclerosis
Abstract
Magnetic resonance imaging is a highly sensitive method for the detection of the lesions of multiple sclerosis and renders possible the study and the evolution of early lesions. Previous reports on magnetic resonance imaging following gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) injection demonstrated that new lesions can be recognized by contrast enhancement. The pathological basis of these observations is uncertain. We have had the opportunity to study at autopsy the brain of a patient with chronic progressive multiple sclerosis who suffered acute worsening leading to death. Magnetic resonance imaging performed 10 days and 4 weeks prior to death showed new Gd-DTPA-enhanced lesions in the posterior hemispheric white matter adjacent to the lateral ventricles. Light microscopic examination of these areas demonstrated them to be fresh lesions comprising intense inflammatory activity and dense perivascular cuffs within an edematous lesion center and a striking parenchymal mononuclear cell infiltration at the margins of the lesions. Lesions that were demonstrated by increased signal on T2-weighted images, but were not enhanced following administration of Gd-DTPA, were all of the chronic type, either inactive or active. None of these showed the intense inflammatory activity of the acute lesions and most displayed fibrous astrogliosis.
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Aside from a relationship between Gd enhancement and inflammation, conventional MRI techniques do not distinguish other histopathological substrates of MS.
“Aside from a relationship between Gd enhancement and inflammation (Hawkins et al., 1990; Katz et al., 1993), however, such conventional MRI (cMRI) techniques do not distinguish other histopathological substrates of MS (Moore, 2003).”
From Diffusion tensor imaging of post mortem multiple sclerosis brain (2007) · cites this paper as Katz et al., 1993
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- Authors
- Katz, D., Taubenberger, J. K., Cannella, B., McFarlin, D. E., Raine, C. S., & McFarland, H. F.
- Affiliations
- National Institutes of Health (US)
- Albert Einstein College of Medicine (US)
- National Institute of Neurological Disorders and Stroke (US)
- Corresponding author
- Katz, David
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 1993-11
- Volume
- 34
- Issue
- 5
- Pages
- 661-669
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W2017449946
- Cited by
- 387
- References
- 0
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 2 · 2016: 7 · 2015: 9 · 2014: 9 · 2013: 7 · 2012: 17
- FWCI
- 13.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (NS-08952, NS-11920, R01NS008952)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Keywords
- multiple sclerosis, Gd-DTPA, contrast enhancement, lesion evolution, perivascular cuffs, mononuclear cell infiltration, astrocyte activation, T2-weighted signal intensity, white matter lesions, autopsy correlation, inflammatory activity
- MeSH terms
- Adult, Brain, Cerebral Cortex, Chronic Disease, Contrast Media, Pentetic Acid, Female, HLA Antigens, Humans, Immunohistochemistry, Macrophages, Magnetic Resonance Imaging, Multiple Sclerosis, Organometallic Compounds, Pons, Spinal Cord, Gadolinium DTPA
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