HypoIntense & HyperIntense Lesions
On Magnetic Resonance Imaging
In Secondary/Progressive MS

Adams H, Wagner S, Sobel DF, Slivka LS, Sipe JC, Romine JS, Beutler E, Koziol JA
Eur Neurol 1999 Jul;42(1):52-63
The Scripps Research Institute, Dept of Molecular and Experimental Medicine, La Jolla, Calif., USA
PMID# 10394049
Abstract

Cranial Magnetic Resonance Imaging (MRI) is widely used to monitor disease activity in clinical trials in Multiple Sclerosis (MS).

The purpose of this study is to examine Lesion Burden as determined from HypoIntense regions on postcontrast T1-weighted scans (or black holes), and lesion burden on conventional T2-weighted scans.

From a cohort of Secondary/Progressive MS patients who participated in a placebo-controlled, randomized, double-blind cross-over trial assessing the therapeutic efficacy of Cladribine.

T2 lesion volumes and black hole volumes are approximately normal distributed when log-transformed, and are highly correlated (adjusted R2 = 0.63).

Changes in clinical scores could be predicted with a reasonable degree of precision from baseline scores and changes in T2 lesion volumes (adjusted R2 values = 0.52-0.7).

Stratification schemes for clinical trials should include:

  1. The acute proportion of the disease
  2. Degree of permanent damage (Black Holes)
  3. T2 Lesion Volume

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