Download PDF
Dtsch Med Wochenschr 2000; 125(45): 1375-1380
DOI: 10.1055/s-2000-8177
Übersichten
© Georg Thieme Verlag Stuttgart · New York

Kernspintomografie bei Multipler Sklerose

H.-F Petereit1 , P. Impekoven 2 , S. Bamborschke1 , G . Pawlik1
  • Klinik und Poliklinik für Neurologie (Direktor: Prof. Dr. W.-D. Heiss) und
  • Institut und Poliklinik für Radiologische Diagnostik (Direktor: Prof. Dr. K. Lackner) der Universität zu Köln
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
   Permissions and Reprints
Preview

Die Encephalomyelitis disseminata oder Multiple Sklerose (MS) ist eine häufige Erkrankung des mittleren Lebensalters mit unbekannter, vermutlich autoimmuner Ätiologie, die durch Entzündungsherde, Entmarkung und reaktive Gliose vorwiegend in der weißen Substanz des zentralen Nervensystems gekennzeichnet ist. Die Diagnose stützt sich auf Anamnese und klinischen Befund mit Nachweis örtlich und zeitlich disseminierter Symptome sowie auf den Nachweis eines chronisch entzündlichen Liquorsyndroms. Welchen Beitrag die Kernspintomografie leisten kann, soll dargestellt werden.

Literatur

  • 1 Allen I V, Glover G, Anderson R. Abnormalities in the macroscopically normal white matter in cases of mild or spinal multiple sclerosis.  Acta Neuropathol. 1981;  7 176-178
    Search in Google Scholar
  • 2 Barkhof F, McGowan J C, van Waesberghe J H, Grossmann R I. Hypointense multiple sclerosis lesions on T1-weighted spin echo magnetic resonance images: Their contribution in understanding multiple sclerosis evolution.  J Neurol Neurosurg Psych. 1998;  64 (1) 77-79
    Search in Google Scholar
  • 3 Barnes D, McDonald W I, Landon D N, Johnson G. The characterization of experimental gliosis by quantitative nuclear magnetic resonance imaging.  Brain. 1988;  111 83-94
    Search in Google Scholar
  • 4 Davie C A, Hawkins C P, Barker G J, Brennan A, Tofts P S, Miller D H, McDonald W I. Serial proton magnetic spectroscopy in acute multiple sclerosis lesions.  Brain. 1994;  117 49-58
    Search in Google Scholar
  • 5 Davie C A, Barker G J, Thompson A J, Tofts P S, McDonald W I, Miller D H. 1H magnetic resonance spectroscopy of chronic cerebral white matter lesions and normal appearing white matter in multiple sclerosis.  J Neurol. 1997;  63 736-742
    Search in Google Scholar
  • 6 De Stefano N, Matthews P M, Narayanan S, Francis G S, Antel J P, Arnold D L. Axonal dysfunction and disability in a relapse of multiple sclerosis: Longitudinal study of a patient.  Neurology. 1997;  49 1138-1141
    Search in Google Scholar
  • 7 Droogan A G, Clark C A, Werring D J, Barker G J, McDonald W I, Miller D H. Comparison of multiple sclerosis clinical subgroups using navigated spin echo diffusion-weighted imaging.  MRI. 1999;  17 653-661
    Search in Google Scholar
  • 8 Edwards S G, Gong Q Y, Liu C, Zwartau M E, Jaspan T, Roberts N, Blumhard L D. Infratentoriell atrophy on magnetic resonance imaging and disability in multiple sclerosis.  Brain. 1999;  122 291-301
    Search in Google Scholar
  • 9 European Study Group on Interferon β-1b in Secondary Progressive MS . Placebo-controlled multicentre randomised trial of interferon β-1b in treatment of secondary progressive multiple sclerosis.  Lancet. 1998;  352 1491-1497
    Search in Google Scholar
  • 10 Fazekas F, Offenbacher H, Fuchs S, Schmidt R, Niederkorn K, Horner S, Lechner H. Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis.  Neurology. 1988;  38 1822-1825
    Search in Google Scholar
  • 11 Fazekas F, Barkhof F, Filippi M, Grossmann R I, Li D K, McDonald W I, McFarland H F, Paty D W, Simon J H, Wolinsky J S, Miller D H. The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis.  Neurology. 1999;  53 448-456
    Search in Google Scholar
  • 12 Filippi M, Rovaris M, Capra R, Gasperini C, Yousry T A, Sormani M P, Prandini F, Horsfield M A, Martinelli V, Bastianello S, Kuhne I, Pozilli C, Comi G. A multi-centre longitudinal study comparing the sensitivity of monthly MRI after standard and triple dose gadolineum-DTPA for monitoring disease activity in multiple sclerosis. Implications for phase II clinical trials.  Brain. 1998;  121 2011-2020
    Search in Google Scholar
  • 13 Filippi M, Rocca M A, Rizzo G, Horsfield M A, Rovaris M, Minicucci L, Colomco B, Comi G. Magnetization transfer in multiple sclerosis lesions enhancing after different dosis of gadolineum.  Neurology. 1998;  50 1289-1293
    Search in Google Scholar
  • 14 Filippi M, Rovaris M, Bastianello S, Gasperini C, Origgi D, Reganati P, Pozilli C, Comi G. A comparison of the sensitivity of monthly unenhanced and enhanced MRI techniques in detecting new multiple sclerosis lesions.  J Neurol. 1999;  246 97-106
    Search in Google Scholar
  • 15 Fu L, Matthews P M, De Stefano N, Worsley K J, Narayanan S, Francis G S, Antel J P, Wolfson C, Arnold D L. Imaging axonal loss of normal-appearing white matter in multiple sclerosis.  Brain. 1998;  121 103-113
    Search in Google Scholar
  • 16 Gasperini C, Pozzilli C, Bastianello S, Koudriavtseva T, Galgani S, Millefiorini E, Paolillo A, Horsfield M A, Bozzao L, Fieschi C. Effect of steroids on gadolineum-enhancing lesions before and during recombinant beta interferon 1 a treatment in relapsing remitting multiple sclerosis.  Neurology. 1998;  50 403-406
    Search in Google Scholar
  • 17 Gass A, Radü E W, Filippi M, Kappos L. MRT-Verlaufsuntersuchungen bei Multipler Sklerose. Ein Leitfaden für die Qualitätssicherung.  Akt Radiol. 1999;  170 581-586
    Search in Google Scholar
  • 18 Goodkin D E, Rooney W D, Sloan R, Bacchetti P, Gee L, Vermathen M, Waubant E, Abundo M, Majumar S, Nelson S, Weiner M W. A serial study of new MS lesions and the white matter from which they arise.  Neurology. 1998;  51 1689-1697
    Search in Google Scholar
  • 19 Grossman R I. Magnetization transfer in multiple sclerosis.  Ann Neurol. 1994;  36 97-99
    Search in Google Scholar
  • 20 Hawkins C P, Munro P M, MacKenzie F, Kesselring J, Tofts P S, du Boulay E P, Landon D N, McDonald W I. Duration and selectivity of blood-brain barrier breakdown in chronic relapsing experimental allergic encephalomyelitis studies by gadolineum-DTPA and protein markers.  Brain. 1990;  113 365-378
    Search in Google Scholar
  • 21 Katz D, Taubenberger J K, Canella B, McFarlin D E, Raine C S, McFarland H F. Correlation between magnetic resonance imaging findings and lesion development in chronic, active multiple sclerosis.  Ann Neurol. 1993;  34 661-669
    Search in Google Scholar
  • 22 Kermode A G, Thompson A J, Tofts P, McManus D J, Kendall B E, Kingsley D P, Moseley I F, Rudge P, McDonald W I. Breakdown of the blood brain barrier precedes symptoms and other MRI signs of new lesions in multiple sclerosis. Pathogenetic and clinical implications.  Brain. 1990;  113 1477-1489
    Search in Google Scholar
  • 23 Kurtzke J F. Rating neurological impairment in multiple sclerosis: An expanded disability rating scale.  Neurology. 1983;  13 1444-1452
    Search in Google Scholar
  • 24 Lee K H, Hashimoto S A, Hooge J P, Kastrukoff L F, Oger J J, Li D K, Paty D W. Magnetic resonance imaging of the head in the diagnosis of multiple sclerosis: A prospective 2-years follow-up with comparison of clinical evaluation, evoked potentials, oligoclonal bands and CT.  Neurology. 1991;  41 657-660
    Search in Google Scholar
  • 25 Liu C, Edwards S, Gong Q, Roberts N, Blumhardt L D. Three dimensional MRI estimates of brain and spinal cord atrophy in multiple sclerosis.  J Neurol Neurosurg Psych. 1999;  66 323-330
    Search in Google Scholar
  • 26 Losseff N A, Webb S L, O¿Riordan J I, Page R, Wang L, Barker G J, Tofts P S, McDonald W I, Miller D H, Thompson A J. Spinal cord atrophy and disability in multiple sclerosis. A new reproducible and sensitive MRI method with potential to monitor disease progression.  Brain. 1996;  119 701-708
    Search in Google Scholar
  • 27 Millefiorini E, Gasperini C, Pozzilli C, D¿Andrea F, Bastianello S, Trojano M, Morino S, Morra V B, Bozzao A, Calo A, Bernini M L, Gambini D, Prencipe M. Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome.  J Neurol. 1997;  244 153-159
    Search in Google Scholar
  • 28 Miller D F, Barkhof F, Nauta J J. Gadolineum enhancement increases the sensitivity of MRI in detecting disease activity in multiple sclerosis.  Brain. 1993;  116 1077-1094
    Search in Google Scholar
  • 29 Newcombe J, Hawkins C P, Henderson C L, Patel H A, Woodroofe M N, Hayes G M, Cuzner M L, MacManus D, du Bolay E P, McDonald W I. Histopathology of Multiple Sclerosis lesions detected by magnetic resonance imaging in unfixed postmortem central nervous tissue.  Brain. 1991;  114 1013-1023
    Search in Google Scholar
  • 30 Noseworthy J H, Vandervoort M K, Wong C J, Ebers G C. Interrater variability with the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) in a multiple sclerosis trial. The Canadian Cooperation MS Study Group.  Neurology. 1990;  40 971-975
    Search in Google Scholar
  • 31 Offenbacher H, Fazekas F, Schmidt R, Freidl W, Flooh E, Payer F, Lechner H. Assessment of MRI criteria for a diagnosis of MS.  Neurology. 1993;  43 905-909
    Search in Google Scholar
  • 32 O¿Riordan J I, Thompson A J, Kingsley D P, MacManus D G, Kendall B E, Rudge P, McDonald W I, Miller D H. The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year follow-up.  Brain. 1998;  121 495-503
    Search in Google Scholar
  • 33 Poser C M, Paty D W, Scheinberg L C, McDonald W I, Davis F A, Ebers G C, Johnson K P, Sibley W A, Silberberg D H, Tourtelotte W W. New diagnostic criteria for multiple sclerosis: Guidelines for research protocols.  Ann Neurol. 1983;  13 227-231
    Search in Google Scholar
  • 34 PRISMS Study Group . Randomised placebo-controlled double-blind study of interferon β-1a in relapsing/remitting multiple sclerosis.  Lancet. 1998;  352 1498-1504
    Search in Google Scholar
  • 35 Richert N D, Ostuni J L, Bash C N, Duyn J H, McFarland H F, Frank J A. Serial whole-brain magnetization transfer imaging in patients with relapsing-remitting multiple sclerosis at baseline and during treatment with interferon beta-1b.  AJNR. 1998;  19 1705-1713
    Search in Google Scholar
  • 36 Sarchielli P, Presciutti O, Tarducci R, Gobbi G, Alberti A, Pelliccioli G P, Orlacchio A, Gallai V. 1H-MRS in patients with multiple sclerosis undergoing treatment with interferon beta-1a: results of a preliminary study.  J Neurol Neurosurg Psych. 1998;  64 204-212
    Search in Google Scholar
  • 37 Smith M E, Stone L A, Albert P S, Frank J A, Martin R, Armstrong M, Maloni H, McFarlin D E, McFarland H F. Clinical worsening in multiple sclerosis is associated with increased frequency and area of gadopentate dimeglumine enhancing magnetic resonance imaging lesions.  Ann Neurol. 1993;  33 480-489
    Search in Google Scholar
  • 38 Sorensen P S, Wanscher B, Jensen C V, Schreiber K, Blinkenberg M, Ravnborg M, Kirsmeier H, Larsen V A, Lee M L. Intravenous immunoglobulin G reduces MRI activity in relapsing multiple sclerosis.  Neurology. 1998;  50 1273-1281
    Search in Google Scholar
  • 39 The IFNB Multiple Sclerosis Study Group and the University of British Colombia MS/MRI Analysis Group . Interferon beta-1b in the treatment of multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial.  Neurology. 1995;  43 1277-1285
    Search in Google Scholar
  • 40 The Lenercept Multiple Sclerosis Study Group and The University of British Columbia MS/MRI Analysis Group . TNF neutralization in MS. Results of a randomized, placebo-controlled multicenter study.  Neurology. 1999;  53 457-465
    Search in Google Scholar
  • 41 Thompson A J, Kermode A G, Wicks D, MacManus D G, Kendall B E, Kingsley D P, McDonald W I. Major differences in the dynamics of primary and secondary progressive multiple sclerosis.  Ann Neurol. 1991;  29 53-62
    Search in Google Scholar
  • 42 Thompson A J, Miller D, Youl B, McManus D, Moore S, Kingsley D, Kendall B, Feinstein A, McDonald W I. Serial gadolineum enhanced MRI in relapsing/remitting multiple sclerosis of varying disease duration.  Neurology. 1992;  42 60-63
    Search in Google Scholar
  • 43 Thompson A J. Frühe Läsionen bei MS. In: Miller DH, Kesselring J, McDonald WI, Paty DW, Thompson AJ (Ed.): Magnetresonanz bei Multipler Sklerose. Kohlhammer, Stuttgart 1998: 128
    Search in Google Scholar
  • 44 Trapp B D, Peterson J, Ransohoff R M, Rudick R, Mörk S, Bö L. Axonal transection in the lesions of multiple sclerosis.  New Engl J Med. 1998;  338 278-285
    Search in Google Scholar
  • 45 Van Walderveen M A, Kamphorst W, Scheltens P, van Waesberghe J H, Ravid R, Valk J, Polman C H, Barkhof F. Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis.  Neurology. 1998;  50 1282-1288
    Search in Google Scholar
  • 46 Van Walderveen M A, Truyen L, van Oosten B W, Castelijns J A, Lycklama a Nijeholt G J, van Waesberghe J H, Polman C, Barkhof F. Development of hypointense lesions on T1-weighted spin-echo magnetic resonance images in multiple sclerosis: Relation to inflammatory activity.  Arch Neurol. 1999;  56 345-351
    Search in Google Scholar
  • 47 Wolansky L J, Finden S G, Chang R, Conigliari M, Lee H J, Shaderowsky P D, Cook S D. Gadoteridol in multiple sclerosis patients. A comparison of single and triple dose with immediate vs. delayed imaging.  Clin Imaging. 1998;  22 385-392
    Search in Google Scholar

Korrespondenz

Dr. H.-F. Petereit

Klinik und Poliklinik für Neurologie und Psychiatrie - Neurologie Universität zu Köln

Josef-Stelzmann-Straße 9

50924 Köln

Phone: 0221/478-4014

Fax: 0221/478-6708

Email: hela.petereit@medizin.uni-koeln.de