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  • 1
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; Multiple sclerosis ; Pulse sequences ; Lesion load
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Changes on serial assessments of brain MRI lesion load are used for monitoring therapeutic efficacy in patients with multiple sclerosis (MS). We assessed the accuracy and reliability of conventional spin-echo (CSE) and fast spin-echo (FSE) sequences for measurement of lesion volume using a semiautomated contour technique. Cranial CSE and FSE examinations of 18 patients with secondary progressive MS were studied. The mean lesion load was slightly higher with the CSE sequence (p = 0.002). Intraobserver variability was significantly higher for FSE than for CSE, according to both the coefficient of variation between two measurements (mean 2.48 % and 1.35 % respectively, p 〈 0.05) and back-transformed 95 % limits of agreement (1.005–1.060 for FSE; 0.988–1.019 for CSE). Although FSE sequences are quicker and the total lesion volume measurements are similar to those obtained with CSE, the poorer reproducibility raises doubts about the use of FSE to replace CSE in clinical trials.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1459
    Keywords: Key words Magnetic resonance imaging ; Turbo spin echo ; Fast fluid attenuated inversion recovery ; Systemic autoimmune diseases ; Brain lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fast fluid-attenuated inversion recovery (fFLAIR) is more sensitive that conventional or fast spin echo T2-weighted magnetic resonance imaging (MRI) for detecting lesions in the brain of patients with ischemic, inflammatory, or demyelinating diseases of the CNS. We ¶investigated whether the use of fFLAIR also increases the sensitivity of brain MRI assessment in patients with systemic autoimmune disorders. Turbo spin echo (TSE) dual-echo and fFLAIR scans of the brain were obtained from patients affected by systemic lupus erythematosus (SLE) with (NSLE, n = 9) and without clinical CNS involvement (n = 15), Behçet disease (n = 5), Wegener granulomatosis (n = 9), and antiphospholipid antibody syndrome (n = 6). Brain hyperintense lesions were counted and classified according to their size and their location by two observers by consensual agreement. The total lesion volume was measured using a semiautomated technique for lesion segmentation on both TSE and fFLAIR scans. The imaging modalities showed brain hyperintense lesions in all 9 SLE patients with CNS involvement, 5 of 15 SLE patients without CNS involvement, 5 of 9 patients with Wegener granulomatosis, 1 of 5 with Behçet disease, and 3 of 6 with antiphospholipid antibody syndrome. ¶A total of 342 lesions were seen on both sequences; 88 were seen only on TSE and 54 only on fFLAIR scans. The average number of brain lesions per scan was higher on TSE than on fFLAIR, since significantly more discrete (P 〈 0.002) and small (P = 0.004) lesions were seen on TSE than on fFLAIR. The median total lesion volume, however, was similar on TSE and fFLAIR. Our study indicates that the use of fFLAIR does not improve the sensitivity of fast dual-echo MRI for detecting brain abnormalities in patients with systemic autoimmune disorders.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 17 (1996), S. 385-391 
    ISSN: 1590-3478
    Keywords: Multiple Sclerosis ; Magnetic Resonance ; Clinical Trials ; Natural History
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario In questo articolo vengono presi in esame i principali contributi che le tecniche di risonanza magnetica (RM) forniscono per il monitoraggio del decorso della sclerosi multipla (SM), sia esso naturale o modificato da interventi terapeutici. Le correlazioni riscontrate tra parametri di RM ed attività a breve termine della malattia rendono appropriato l'uso di tali misure come end-point primari in trial di fase II volti ad esplorare la efficacia di nuovi trattamenti. Le correlazioni tra parametri di RM ed evoluzione clinica a lungo termine sono invece modeste nelle forme clinicamente definite di malattia e pertanto tali misure sono attualmente utilizzate esclusivamente come end-point secondari nei trial di fase III. In questo articolo vengono inoltre presentati i risultati ottenuti dall'applicazione clinica di nuove tecniche non convenzionali di RM, nonché il loro possibile ruolo futuro nel monitorare l'efficacia dei trattamenti volti a prevenire lo sviluppo di disabilità in pazienti con SM.
    Notes: Abstract In this review the main contributions of magnetic resonance (MR) techniques in the monitoring of multiple sclerosis (MS) course, both natural or modified by treatments, are presented. MR measures well correlate with short-term disease evolution and therefore their use is appropriate as primary end-points in preliminary clinical trials evaluating the effects of new treatments. In contrast, the correlation between MR measures and long-term clinical evolution in clinically definite MS is less clear, thus indicating that such measures can be used at present only as a secondary end-point in large scale definitive trials. The results coming from the clinical application of newer MR techniques with higher pathological specificity are also presented and their possible future roles in monitoring treatment aimed at preventing development of disability in MS are discussed.
    Type of Medium: Electronic Resource
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