The Effect of Gadolinium Enhancing Lesions on Whole Brain Atrophy in Relapsing-Remitting Multiple Sclerosis

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Gadolinium enhancing lesions on Tl-weighted MR images reflect abnormalities in the blood-brain barrier (BBB), and are used as measures of active inflammation. Enhancement has been found to precede the development of chronic lesions and clinical symptoms, suggesting that BBB breakdown may be linked to the demyelinating process. Recently, the process of atrophy in MS has begun to be evaluated using quantitative MRI. Studies have found significant atrophy of me spinal cord, corpus callosum. cerebellum, and cerebrum The mechanism of atrophy in MS has yet to be elucidated but potentially involves multiple processes. It has been suggested that BBB breakdown is the seminal event in the pathogenesis of atrophy in MS. In this study, a semi-automated whole brain segmentation method based on high-resolution dual fast spin-echo was used to determine whether whole brain atrophy over a 2yeat period is related to initial inflammatory activity.