Triple doseofgadolinium-DTPA anddelayed MRI inpatients withbenign multiple sclerosis

Objectives-To evaluate whetheratriple doseofgadolinium-DTPA (Gd-DTPA)or delayed MRI increase thenumber,size, andconspicuousness ofenhancing lesions inpatients withbenignmultiple sclerosis. Methods-TlweightedbrainMRI was carried outon 20patients withbenign multiple sclerosis (expandeddisability statusscale 10years)intwosessions. Inthefirst session, onescanwasobtained before and twoscansfive tosevenminutesand20-30 minutesafter theinjection of0-1mmollkg Gd-DTPA (standard dose). Inthesecond session, sixto24hourslater, thesame procedure wasrepeated with0*3mmol/kg Gd-DTPA(triple dose). Results-Nineenhancinglesionswere foundinsevenpatients (35%)usingthe standard doseofGd-DTPA.Thenumbers ofenhancing lesions increased to13(P= 0.03) andthenumberofpatients with suchlesions toeight (40%)onthedelayed standard dosescans.On theearlytriple dosescans, wefound19enhancing lesions in 10 patients (50%).The numberof enhancing lesions wassignificantly higher (P= 0.01) thanthatobtained withthe earlystandarddose.The numberof enhancing lesions was18andthenumber of active patients 11(55%)on the delayed triple dosescans.Theenhancing areasincreased progressively fromthe early standard dosescanstothedelayed triple dosescans.Thecontrast ratios of thelesions detected intheearly standard dosescanswaslowerthanthoseoflesions presentin the early(P= 0-01)and delayed (P= 0.04) triple dosescans. Conclusions-More enhancinglesions were detected inpatients withbenign multiple sclerosis withbothdelay ofMRI andtheuseofatriple doseofGd-DTPA suggesting thattheamountofinflammationinthelesions ofsuchpatients ismild andheterogeneous. (3Neurol Neurosurg Psychiatry 1996;60:526-530)