The value of magnetic resonance imaging in diagnosis and monitoring of treatment in multiple sclerosis

We analysed MR examinations of 277 patients with multiple sclerosis. White matter hyperintensities in brain were found in 270 of them. The most frequently they were found in periventricular white matter (in 100% of cases), in subcortical localization (52.2%) and in the corpus callosum (44.4%). MR examination allows to estimate the activity of the disease on the basis of the presence of oedema around the plaques and their contrast enhancement with gadopentetate dimeglumine (Gd-DTPA). 17.8% of all cases showed the signs of the acute phase of MS. About one-third of all cases were accompanied by cortical brain atrophy (the most often seen in the frontal lobes), subcortical brain atrophy was less frequent (one-sixth). In about two-third of all cases the corpus callosum atrophy was found. The analysis of follow-up MR examinations of 83 patients taking part in a double-blind placebo-controlled trial of a new immunosuppressive drug cladribine showed that patients from the placebo group were more compliant to any changes of the plaques. Decrease of the plaques size was found mainly in women. No correlation between the patients age and the plaques changes was established.