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Ring-enhancement in multiple sclerosis: marker of disease severity

Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA

N O Jeffries

Biostatistics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA

R Stone

Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA

R Martin

Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA

N D Richert

Laboratory for Diagnostic Radiology Research, National Institutes of Health, Bethesda, Maryland, USA

J A Frank

Laboratory for Diagnostic Radiology Research, National Institutes of Health, Bethesda, Maryland, USA

H F McFarland

Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA

Correlations between conventional MRI measures of disease activity and clinical disability in multiple sclerosis (MS) have been disappointing. Because ring-enhancing lesions may reflect a more destructive pathology, we tested their potential association with disease severity. We evaluated active lesions with regard to their enhancement pattern on serial magnetic resonance images in a cohort of 28 patients with relapsing-remitting MS. The percentage of ring-enhancing lesions correlated with EDSS, T2 lesion load and duration of disease and predicted the occurrence of relapses during the baseline period of observation as well as after 3 years of follow-up in multiple logistic regression analysis. The findings suggest that the pathological process reflected by ring-enhancing lesions may contribute to more severe clinical disease.

Key Words: multiple sclerosis • magnetic resonance • ring-enhancing lesions • enhancement pattern

Multiple Sclerosis, Vol. 7, No. 3, 167 (2001)
DOI: 10.1177/135245850100700306


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