Enhancing magnetic resonance imaging lesions and cerebral atrophy in patients with relapsing multiple sclerosis.

OBJECTIVE

To examine the relation between the frequency of enhancing magnetic resonance imaging lesions and their characteristics of enhancement and atrophy in patients with early relapsing multiple sclerosis.

DESIGN

Analysis of number of enhancing lesions, ventricular volumes and diameters, and lesion characteristics on monthly magnetic resonance imaging scans during natural history follow-up.

SETTING

A clinical research institution.

PATIENTS: Sixteen patients with confirmed early relapsing multiple sclerosis.

MAIN OUTCOME MEASURE: Cerebral atrophy as measured by ventricular enlargement.

RESULTS

Numbers of enhancing lesions correlated well with an increase of ventricular size. This correlation was strongest for patients with a high proportion of concentric ring-enhancing lesions with central contrast pallor.

CONCLUSIONS

Inflammatory events, especially those within lesions with associated blood-brain barrier breakdown, affect the ensuing loss of brain parenchyma. Patients with a high proportion of lesions with central contrast pallor, which is likely associated with more extensive tissue damage, have a higher rate of atrophic changes.