Multiple sclerosis: specificity of MR for diagnosis

Article Abstract:

Multiple sclerosis (MS) is a disease of the nervous system that mainly affects young adults. It is characterized by patches or plaques on the white matter of the brain and spinal cord, which can be detected by magnetic resonance (MR) imaging. The ability of MR to differentiate types and causes of these patches is not known, however, and thus a study was conducted to evaluate the ability of MR to differentiate between plaques characteristic of MS and those of other origin. The subjects consisted of 92 patients diagnosed with MS, as well as 100 healthy subjects, 60 subjects with hypertension, and 8 subjects with Alzheimer's disease. Conventional MR images of the head were obtained from all the subjects. Areas of high signal intensity were found on the images of 90 percent of the MS subjects, 90 percent of the Alzheimer subjects, 40 percent of the hypertensive patients, and 35 percent of the healthy volunteers. A specific diagnosis of MS was accurately obtained using MR images only in over 90 percent of the subjects, even when healthy controls were left out of the control group. The sensitivity of MS diagnosis ranged from 68 to 80 percent. There were seven false-positive readings of MS in non-MS subjects when MR, sex and age data were known, and 13 when only MR data was known. The results indicate that the combined data from MR imaging and the sex and age of the patient can be highly specific in diagnosing MS, with a small chance of identifying a healthy subject as having MS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Multiple sclerosis, Brain diseases

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Multicenter study of gadodiamide injection as a contrast agent in MR imaging of the brain and spine

Article Abstract:

Magnetic resonance (MR) imaging is a diagnostic imaging technique that uses the magnetic properties of elements to produce clearly differentiated images of tissues and organs. One of its uses is imaging the head and spine for detecting abnormalities of the central nervous system (CNS). As with other imaging techniques, contrast agents often help enhance MR images and allow for more accurate detection of abnormalities. This study examined the effectiveness and safety of the nonionic compound gadodiamide in MR imaging. MR imaging of the brain and spine along with injection of gadodiamide was performed on 439 patients who had either suspected or known CNS abnormalities. Adverse side effects from the agent were reported by 46 (10.5 percent) of the patients. Headaches, nausea, and dizziness were the most commonly reported side effects; no serious side effects were reported. CNS abnormalities were detected by MR imaging, with or without the contrast agent, in 353 (80.4 percent) of the patients. The gadodiamide enhanced imaging of these abnormalities in 266 of the 353 patients. In 28 patients, no abnormality was seen when MR imaging without gadodiamide was performed. Gadodiamide enhancement changed the diagnosis for 70 patients and facilitated diagnosis for 190 patients. These results indicate that gadodiamide is both safe and effective for use as a MR imaging contrast agent when evaluating possible CNS abnormalities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Central nervous system, Nonionic contrast media

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MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery

Article Abstract:

Gadolinium was used as a contrast agent to enhance magnetic resonance (MR) images of the facial nerve in ten patients suffering from Bell's palsy. Bell's palsy is the sudden onset of facial paralysis affecting one side of the face and usually spontaneously disappears within six months of the onset. Suspected causes of Bell's palsy include viral inflammation, central nervous system disorders, and immunologic factors. Studies have shown, however, that in some cases the facial nerve becomes edematous (swollen) and compressed. MR imaging is not recommended as a routine test for Bell's palsy. Because the palsy disappears of its own accord, routine observation is the suggested treatment unless the symptoms persist. MR enhanced imaging of the facial nerve may be important in diagnosing other syndromes involving facial nerve inflammation, particularly if tumor involvement is suspected as a cause.

Surgery, Temporal bone, Facial nerve, Paralysis, Facial, Facial paralysis

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