Utilização de Gadolínio nas Ressonâncias Magnéticas de Controlo em Doentes com Esclerose Múltipla: Recomendações Atuais
DOI:
https://doi.org/10.20344/amp.20467Palavras-chave:
Esclerose Múltipla/diagnóstico por imagem, Gadolínio, Meios de Contraste, Ressonância MagnéticaResumo
A esclerose múltipla é a doença desmielinizante do sistema nervoso central mais frequente, caracterizando-se pelo início precoce e incapacidade progressiva. A ressonância magnética, pela elevada sensibilidade e especificidade na deteção de lesões desmielinizantes, é o exame complementar mais útil nesta patologia, sendo a administração de meios de contraste com gadolínio um importante contributo na interpretação imagiológica. Embora o contraste seja imprescindível no âmbito do diagnóstico, a sua utilização por rotina na monitorização da atividade de doença, resposta ao tratamento e respetivas complicações é controversa. O objetivo deste artigo é reunir as recomendações atuais relativas à utilização do gadolínio no seguimento imagiológico da esclerose múltipla e definir um protocolo clínico efetivo e seguro. A revisão da literatura foi conduzida na PubMed, recorrendo aos termos ‘esclerose múltipla’, ‘ressonância magnética’ e ‘gadolínio’ ou ‘meio de contraste’. Foram selecionados artigos publicados entre janeiro de 2013 e de 2023 relativos à segurança do gadolínio e à sua utilização na ressonância magnética de controlo dos doentes adultos com diagnóstico de esclerose múltipla. Apesar de nenhuma consequência biológica ou clínica ter sido inequivocamente atribuída à retenção cerebral do gadolínio, que foi reportada maioritariamente com agentes lineares, as autoridades de saúde têm vindo a recomendar a restrição do contraste a circunstâncias clínicas essenciais. Na esclerose múltipla, a deteção de lesões subclínicas com captação de gadolínio sem tradução em lesões novas/aumentadas nas sequências ponderadas em T2 ocorre raramente e com impacto na decisão terapêutica questionável. Por outro lado, o gadolínio assume uma sensibilidade superior no diagnóstico diferencial de surtos clínicos, na deteção de atividade inflamatória recente, antes e após o início de uma terapêutica e nos doentes com elevada carga lesional ou lesões difusas/confluentes nas sequências ponderadas em T2. Contrariamente ao rastreio da leucoencefalopatia multifocal progressiva, a monitorização da síndrome inflamatória de reconstituição imunológica beneficia também da inclusão do gadolínio. É exequível e segura a exclusão do gadolínio no seguimento imagiológico de rotina da esclerose múltipla, apesar do seu contributo adicional em circunstâncias clínicas específicas que devem ser do conhecimento articulado do neurologista e neurorradiologista.
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Kavaliunas A, Danylaite Karrenbauer V, Hillert J. Socioeconomic consequences of multiple sclerosis-a systematic literature review. Acta Neurol Scand. 2021;143:587-601. DOI: https://doi.org/10.1111/ane.13411
Branco M, Alves I, Martins da Silva A, Pinheiro J, Sá MJ, Correia I, et al. The epidemiology of multiple sclerosis in the entre Douro e Vouga region of northern Portugal: a multisource population-based study. BMC Neurol. 2020;20:195. DOI: https://doi.org/10.1186/s12883-020-01755-8
Mattay RR, Davtyan K, Bilello M, Mamourian AC. Do all patients with multiple sclerosis benefit from the use of contrast on serial followup MR imaging? A retrospective analysis. AJNR Am J Neuroradiol. 2018;39:2001-6. DOI: https://doi.org/10.3174/ajnr.A5828
Dighriri IM, Aldalbahi AA, Albeladi F, Tahiri AA, Kinani EM, Almohsen RA, et al. An overview of the history, pathophysiology, and pharmacological interventions of multiple sclerosis. Cureus. 2023;15:e33242. DOI: https://doi.org/10.7759/cureus.33242
McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001;50:121-7. DOI: https://doi.org/10.1002/ana.1032
Martín-Aguilar L, Presas-Rodriguez S, Rovira À, Capellades J, Massuet-Vilamajó A, Ramió-Torrentà L, et al. Gadolinium-enhanced brain lesions in multiple sclerosis relapse. Neurologia. 2022;37:557-63. DOI: https://doi.org/10.1016/j.nrl.2021.10.005
Gentili L, Capuano R, Gaetani L, Fiacca A, Bisecco A, d’Ambrosio A, et al. Impact of post-contrast MRI in the definition of active multiple sclerosis. J Neurol Sci. 2022;440:120338. DOI: https://doi.org/10.1016/j.jns.2022.120338
Sadigh G, Saindane AM, Waldman AD, Lava NS, Hu R. Comparison of unenhanced and gadolinium-enhanced imaging in multiple sclerosis: is contrast needed for routine follow-up MRI? AJNR Am J Neuroradiol. 2019;40:1476-80. DOI: https://doi.org/10.3174/ajnr.A6179
Filippi M, Preziosa P, Banwell BL, Barkhof F, Ciccarelli O, De Stefano N, et al. Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines. Brain. 2019;142:1858-75. DOI: https://doi.org/10.1093/brain/awz144
Wattjes MP, Ciccarelli O, Reich DS, Banwell B, de Stefano N, Enzinger C, et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. 2021;20:653-70. DOI: https://doi.org/10.1016/S1474-4422(21)00095-8
Maghzi AH, Sicotte NL, Waubant E. Do you believe in Gad? Mult Scler Relat Disord. 2020;44:102299. DOI: https://doi.org/10.1016/j.msard.2020.102299
Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162-73. DOI: https://doi.org/10.1016/S1474-4422(17)30470-2
Granziera C, Reich DS. Gadolinium should always be used to assess disease activity in MS - Yes. Mult Scler. 2020;26:765-6. DOI: https://doi.org/10.1177/1352458520911174
Asadollahzade E, Ghadiri F, Ebadi Z, Moghadasi AN. The benefits and side effects of gadolinium-based contrast agents in multiple sclerosis patients. Rev Assoc Med Bras. 2022;68:979-81. DOI: https://doi.org/10.1590/1806-9282.20220643
Rovira À, Wattjes MP. Gadolinium should always be used to assess disease activity in MS - No. Mult Scler. 2020;26:767-9. DOI: https://doi.org/10.1177/1352458520914819
Woolen SA, Shankar PR, Gagnier JJ, MacEachern MP, Singer L, Davenport MS. Risk of nephrogenic systemic fibrosis in patients with stage 4 or 5 chronic kidney disease receiving a group ii gadoliniumbased contrast agent: a systematic review and meta-analysis. JAMA Intern Med. 2020;180:223-30. DOI: https://doi.org/10.1001/jamainternmed.2019.5284
Kanda T, Ishii K, Kawaguchi H, Kitajima K, Takenaka D. High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1- weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology. 2014;270:834-41. DOI: https://doi.org/10.1148/radiol.13131669
McDonald RJ, McDonald JS, Kallmes DF, Jentoft ME, Murray DL, Thielen KR, et al. Intracranial gadolinium deposition after contrastenhanced MR imaging. Radiology. 2015;275:772-82. DOI: https://doi.org/10.1148/radiol.15150025
Roccatagliata L, Vuolo L, Bonzano L, Pichiecchio A, Mancardi GL. Multiple sclerosis: hyperintense dentate nucleus on unenhanced T1- weighted MR images is associated with the secondary progressive subtype. Radiology. 2009;251:503-10. DOI: https://doi.org/10.1148/radiol.2511081269
Hannoun S, Issa R, El Ayoubi NK, Haddad R, Baalbaki M, Yamout BI, et al. Gadoterate meglumine administration in multiple sclerosis has no effect on the dentate nucleus and the globus pallidus signal intensities. Acad Radiol. 2019;26:e284-91. DOI: https://doi.org/10.1016/j.acra.2018.11.010
Malhotra A, LeSar B, Wu X, Durand D, Das N, Anzai Y, et al. Progressive T1 shortening of the dentate nucleus in patients with multiple sclerosis: result of multiple administrations of linear gadolinium contrast agents versus intrinsic disease. AJR Am J Roentgenol. 2018;211:1099-105. DOI: https://doi.org/10.2214/AJR.17.19155
Tedeschi E, Palma G, Canna A, Cocozza S, Russo C, Borrelli P, et al. In vivo dentate nucleus MRI relaxometry correlates with previous administration of Gadolinium-based contrast agents. Eur Radiol. 2016;26:4577-84. DOI: https://doi.org/10.1007/s00330-016-4245-2
Forslin Y, Martola J, Bergendal Å, Fredrikson S, Wiberg MK, Granberg T. Gadolinium Retention in the brain: an MRI relaxometry study of linear and macrocyclic gadolinium-based contrast agents in multiple sclerosis. AJNR Am J Neuroradiol. 2019;40:1265-73. DOI: https://doi.org/10.3174/ajnr.A6112
Barisano G, Bigjahan B, Metting S, Cen S, Amezcua L, Lerner A, et al. Signal Hyperintensity on unenhanced T1-weighted brain and cervical spinal cord MR Images after multiple doses of linear gadolinium-based contrast agent. AJNR Am J Neuroradiol. 2019;40:1274-81. DOI: https://doi.org/10.3174/ajnr.A6148
Errante Y, Cirimele V, Mallio CA, Di Lazzaro V, Zobel BB, Quattrocchi CC. Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered gadodiamide in patients with normal renal function, suggesting dechelation. Invest Radiol. 2014;49:685-90. DOI: https://doi.org/10.1097/RLI.0000000000000072
Food and Drug Administration. FDA Drug Safety Communication: FDA evaluating the risk of brain deposits with repeated use of gadoliniumbased contrast agents for magnetic resonance imaging (MRI). [cited 2022 May 15]. Available from: https://www.fda.gov/drugs/drug-safetyand-availability/fda-drug-safety-communication-fda-evaluating-riskbrain-deposits-repeated-use-gadolinium-based.
Grahl S, Bussas M, Pongratz V, Kirschke JS, Zimmer C, Berthele A, et al. T1-weighted intensity increase after a single administration of a linear gadolinium-based contrast agent in multiple sclerosis. Clin Neuroradiol. 2021;31:235-43. DOI: https://doi.org/10.1007/s00062-020-00882-6
Schlemm L, Chien C, Bellmann-Strobl J, Dörr J, Wuerfel J, Brandt AU, et al. Gadopentetate but not gadobutrol accumulates in the dentate nucleus of multiple sclerosis patients. Mult Scler. 2017;23:963-72. DOI: https://doi.org/10.1177/1352458516670738
Gulani V, Calamante F, Shellock FG, Kanal E, Reeder SB. Gadolinium deposition in the brain: summary of evidence and recommendations. Lancet Neurol. 2017;16:564-70. DOI: https://doi.org/10.1016/S1474-4422(17)30158-8
Murata N, Gonzalez-Cuyar LF, Murata K, Fligner C, Dills R, Hippe D, et al. Macrocyclic and other non-group 1 gadolinium contrast agents deposit low levels of gadolinium in brain and bone tissue: preliminary results from 9 patients with normal renal function. Invest Radiol. 2016;51:447-53. DOI: https://doi.org/10.1097/RLI.0000000000000252
DeBevits JJ, Munbodh R, Bageac D, Wu R, DiCamillo PA, Hu C, et al. Gray matter nucleus hyperintensity after monthly triple-dose gadopentetate dimeglumine with long-term magnetic resonance imaging. Invest Radiol. 2020;55:629-35. DOI: https://doi.org/10.1097/RLI.0000000000000663
Kang H, Hii M, Le M, Tam R, Riddehough A, Traboulsee A, et al. Gadolinium deposition in deep brain structures: relationship with dose and ionization of linear gadolinium-based contrast agents. AJNR Am J Neuroradiol. 2018;39:1597-603. DOI: https://doi.org/10.3174/ajnr.A5751
Eisele P, Szabo K, Ebert A, Radbruch A, Platten M, Schoenberg SO, et al. Diffusion-weighted imaging of the dentate nucleus after repeated application of gadolinium-based contrast agents in multiple sclerosis. Magn Reson Imaging. 2019;58:1-5. DOI: https://doi.org/10.1016/j.mri.2019.01.007
Eisele P, Szabo K, Alonso A, Ong M, Platten M, Schoenberg SO, et al. Lack of T1 hyperintensity in the dentate nucleus after 15 administrations of a macrocyclic contrast agent in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2018;89:324-6. DOI: https://doi.org/10.1136/jnnp-2017-316102
Hannoun S, Kocevar G, Codjia P, Maucort-Boulch D, Cotton F, Vukusic S, et al. Signal intensity evaluation in the dentate nucleus and subcortical gray matter: effect of several administrations of gadoterate meglumine in multiple sclerosis. Clin Neuroradiol. 2022;32:677-85. DOI: https://doi.org/10.1007/s00062-021-00995-6
Tedeschi E, Cocozza S, Borrelli P, Ugga L, Morra VB, Palma G. Longitudinal assessment of dentate nuclei relaxometry during massive gadobutrol exposure. Magn Reson Med Sci. 2018;17:100-4. DOI: https://doi.org/10.2463/mrms.cr.2016-0137
Jaulent P, Hannoun S, Kocevar G, Rollot F, Durand-Dubief F, Vukusic S, et al. Weekly enhanced T1-weighted MRI with gadobutrol injections in MS patients: is there a signal intensity increase in the dentate nucleus and the globus pallidus? Eur J Radiol. 2018;105:204-8. DOI: https://doi.org/10.1016/j.ejrad.2018.06.011
Stojanov DA, Aracki-Trenkic A, Vojinovic S, Benedeto-Stojanov D, Ljubisavljevic S. Increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W magnetic resonance images in patients with relapsing-remitting multiple sclerosis: correlation with cumulative dose of a macrocyclic gadolinium-based contrast agent, gadobutrol. Eur Radiol. 2016;26:807-15. DOI: https://doi.org/10.1007/s00330-015-3879-9
Splendiani A, Perri M, Marsecano C, Vellucci V, Michelini G, Barile A, et al. Effects of serial macrocyclic-based contrast materials gadoterate meglumine and gadobutrol administrations on gadolinium-related dentate nuclei signal increases in unenhanced T1-weighted brain: a retrospective study in 158 multiple sclerosis (MS) patients. Radiol Med. 2018;123:125-34. DOI: https://doi.org/10.1007/s11547-017-0816-9
European Medicines Agency. EMA’s final opinion confirms restrictions on use of linear gadolinium agents in body scans. European Medicines Agency. 2017 [cited 2022 Jul 29]. Available from: https://www.ema.europa.eu/en/news/emas-final-opinion-confirms-restrictions-use-lineargadolinium-agents-body-scans.
Eisele P, Konstandin S, Szabo K, Ong M, Zöllner F, Schad LR, et al. Sodium MRI of T1 high signal intensity in the dentate nucleus due to gadolinium deposition in multiple sclerosis. J Neuroimaging. 2017;27:372-5. DOI: https://doi.org/10.1111/jon.12448
Kühn I, Maschke H, Großmann A, Hauenstein K, Weber MA, Zettl UK, et al. Dentate-nucleus gadolinium deposition on magnetic resonance imaging: ultrasonographic and clinical correlates in multiple sclerosis patients. Neurol Sci. 2022;43:2631-9. DOI: https://doi.org/10.1007/s10072-021-05702-4
Forslin Y, Shams S, Hashim F, Aspelin P, Bergendal G, Martola J, et al. Retention of gadolinium-based contrast agents in multiple sclerosis: retrospective analysis of an 18-year longitudinal study. AJNR Am J Neuroradiol. 2017;38:1311-6. DOI: https://doi.org/10.3174/ajnr.A5211
Cocozza S, Pontillo G, Lanzillo R, Russo C, Petracca M, Di Stasi M, et al. MRI features suggestive of gadolinium retention do not correlate with expanded disability status scale worsening in multiple sclerosis. Neuroradiology. 2019;61:155-62. DOI: https://doi.org/10.1007/s00234-018-02150-4
Zivadinov R, Bergsland N, Hagemeier J, Ramasamy DP, Dwyer MG, Schweser F, et al. Cumulative gadodiamide administration leads to brain gadolinium deposition in early MS. Neurology. 2019;93:e611-23. DOI: https://doi.org/10.1212/WNL.0000000000007892
Perrotta G, Metens T, Absil J, Lemort M, Manto M. Absence of clinical cerebellar syndrome after serial injections of more than 20 doses of gadoterate, a macrocyclic GBCA: a monocenter retrospective study. J Neurol. 2017;264:2277-83. DOI: https://doi.org/10.1007/s00415-017-8631-8
Welk B, McArthur E, Morrow SA, MacDonald P, Hayward J, Leung A, et al. Association between gadolinium contrast exposure and the risk of parkinsonism. JAMA. 2016;316:96-8. DOI: https://doi.org/10.1001/jama.2016.8096
Semelka RC, Ramalho M, AlObaidy M, Ramalho J. Gadolinium in humans: a family of disorders. AJR Am J Roentgenol. 2016;207:229-33. DOI: https://doi.org/10.2214/AJR.15.15842
Burke LM, Ramalho M, AlObaidy M, Chang E, Jay M, Semelka RC. Self-reported gadolinium toxicity: a survey of patients with chronic symptoms. Magn Reson Imaging. 2016;34:1078-80. DOI: https://doi.org/10.1016/j.mri.2016.05.005
Food and Drug Administration. Center for Drug Evaluation and Research. FDA Drug Safety Communication: FDA warns that gadolinium-based contrast agents (GBCAs) are retained in the body; requires new class warnings. [cited 2022 May 20]. Available from: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fdawarns-gadolinium-based-contrast-agents-gbcas-are-retained-body.
Mallio CA, Quattrocchi CC, Rovira À, Parizel PM. Gadolinium deposition safety: seeking the patient’s perspective. AJNR Am J Neuroradiol. 2020;41:944-6. DOI: https://doi.org/10.3174/ajnr.A6586
Eichinger P, Schön S, Pongratz V, Wiestler H, Zhang H, Bussas M, et al. Accuracy of unenhanced MRI in the detection of new brain lesions in multiple sclerosis. Radiology. 2019;291:429-35. DOI: https://doi.org/10.1148/radiol.2019181568
Dadar M, Mahmoud S, Narayanan S, Collins DL, Arnold DL, Maranzano J. Diffusely abnormal white matter converts to T2 lesion volume in the absence of MRI-detectable acute inflammation. Brain. 2022;145:2008-17. DOI: https://doi.org/10.1093/brain/awab448
Río J, Auger C, Rovira À. MR imaging in monitoring and predicting treatment response in multiple sclerosis. Neuroimaging Clin N Am. 2017;27:277-87. DOI: https://doi.org/10.1016/j.nic.2017.01.001
Wattjes MP, Rovira À, Miller D, Yousry TA, Sormani MP, de Stefano MP, et al. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis - establishing disease prognosis and monitoring patients. Nat Rev Neurol. 2015;11:597-606. DOI: https://doi.org/10.1038/nrneurol.2015.157
Johnston G, Johnson T, Solomon AJ, Bazylewicz M, Allison JB, Azalone E, et al. Limited utility of gadolinium contrast administration in routine multiple sclerosis surveillance. J Neuroimaging. 2021;31:103-7. DOI: https://doi.org/10.1111/jon.12805
Zarei F, Ghaedian M, Ghaedian T. The role of contrast-enhanced and non-contrast-enhanced MRI in the follow-up of multiple sclerosis. Acta Radiol. 2021;62:916-21. DOI: https://doi.org/10.1177/0284185120946714
Tsantes E, Curti E, Ganazzoli C, Puci F, Bazzurri V, Fiore A, et al. The contribution of enhancing lesions in monitoring multiple sclerosis treatment: is gadolinium always necessary? J Neurol. 2020;267:2642-7. DOI: https://doi.org/10.1007/s00415-020-09894-1
Karimian-Jazi K, Wildemann B, Diem R, Schwarz D, Hielscher T, Wick W, et al. Gd contrast administration is dispensable in patients with MS without new T2 lesions on follow-up MRI. Neurol Neuroimmunol Neuroinflamm. 2018;5:e480. DOI: https://doi.org/10.1212/NXI.0000000000000480
Rudie JD, Mattay RR, Schindler M, Steingall S, Cook TS, Loevner LA, et al. An initiative to reduce unnecessary gadolinium-based contrast in multiple sclerosis patients. J Am Coll Radiol. 2019;16:1158-64. DOI: https://doi.org/10.1016/j.jacr.2019.04.005
Mattay RR, Davtyan K, Rudie JD, Mattay GS, Jacobs DA, Schindler M, et al. Economic impact of selective use of contrast for routine follow-up MRI of patients with multiple sclerosis. J Neuroimaging. 2022;32:656-66. DOI: https://doi.org/10.1111/jon.12984
Traboulsee A, Li D. Addressing concerns regarding the use of gadolinium in a standardized MRI protocol for the diagnosis and followup of multiple sclerosis. AJNR Am J Neuroradiol. 2016;37:e82-3. DOI: https://doi.org/10.3174/ajnr.A4943
Gasperini C, Prosperini L, Rovira À, Tintoré M, Sastre-Garriga J, Tortorella C, et al. Scoring the 10-year risk of ambulatory disability in multiple sclerosis: the RoAD score. Eur J Neurol. 2021;28:2533-42. DOI: https://doi.org/10.1111/ene.14845
Dallera G, Affinito G, Caliendo D, Petracca M, Carotenuto A, Triassi M, et al. The independent contribution of brain, spinal cord and gadolinium MRI in treatment decision in multiple sclerosis: a population-based retrospective study. Mult Scler Relat Disord. 2022;69:104423. DOI: https://doi.org/10.1016/j.msard.2022.104423
Koch MW, Mostert J, Greenfield J, Liu WQ, Metz L. Gadolinium enhancement on cranial MRI in multiple sclerosis is age dependent. J Neurol. 2020;267:2619-24. DOI: https://doi.org/10.1007/s00415-020-09895-0
Saindane AM. Is gadolinium-based contrast material needed for mri follow-up of multiple sclerosis? Radiology. 2019;291:436-7. DOI: https://doi.org/10.1148/radiol.2019190319
Zecca C, Disanto G, Sormani MP, Riccitelli GC, Cianfoni A, Del Grande F, et al. Relevance of asymptomatic spinal MRI lesions in patients with multiple sclerosis. Mult Scler. 2016;22:782-91. DOI: https://doi.org/10.1177/1352458515599246
Rovira A, Auger C. Spinal cord in multiple sclerosis: magnetic resonance imaging features and differential diagnosis. Semin Ultrasound CT MR. 2016;37:396-410. DOI: https://doi.org/10.1053/j.sult.2016.05.005
Gupta A, Al-Dasuqi K, Xia F, Askin G, Zhao Y, Delgado D, et al. The use of noncontrast quantitative mri to detect gadolinium-enhancing multiple sclerosis brain lesions: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2017;38:1317-22. DOI: https://doi.org/10.3174/ajnr.A5209
Absinta M, Vuolo L, Rao A, Nair G, Sati P, Cortese IC, et al. Gadoliniumbased MRI characterization of leptomeningeal inflammation in multiple sclerosis. Neurology. 2015;85:18-28. DOI: https://doi.org/10.1212/WNL.0000000000001587
Zivadinov R, Ramasamy DP, Hagemeier J, Kolb C, Bergsland N, Schweser F, et al. Evaluation of leptomeningeal contrast enhancement using pre-and postcontrast subtraction 3D-FLAIR imaging in multiple sclerosis. AJNR Am J Neuroradiol. 2018;39:642-7. DOI: https://doi.org/10.3174/ajnr.A5541
Absinta M, Cortese IC, Vuolo L, Nair G, de Alwis MP, Ohayon J, et al. Leptomeningeal gadolinium enhancement across the spectrum of chronic neuroinflammatory diseases. Neurology. 2017;88:1439-44. DOI: https://doi.org/10.1212/WNL.0000000000003820
Weber CE, Wittayer M, Kraemer M, Dabringhaus A, Bail K, Platten M, et al. Long-term dynamics of multiple sclerosis iron rim lesions. Mult Scler Relat Disord. 2022;57:103340. DOI: https://doi.org/10.1016/j.msard.2021.103340
Elliott C, Wolinsky JS, Hauser SL, Kappos L, Barkhof F, Bernasconi C, et al. Slowly expanding/evolving lesions as a magnetic resonance imaging marker of chronic active multiple sclerosis lesions. Mult Scler. 2019;25:1915-25. DOI: https://doi.org/10.1177/1352458518814117
Coffman CH, White R, Subramanian K, Buch S, Bernitsas E, Haacke EM. Quantitative susceptibility mapping of both ring and non-ring white matter lesions in relapsing remitting multiple sclerosis. Magn Reson Imaging. 2022;91:45-51. DOI: https://doi.org/10.1016/j.mri.2022.05.009
Wattjes MP, Wijburg MT, van Eijk J, Frequin S, Uitdehaag BM, Barkhof F, et al. Inflammatory natalizumab-associated PML: baseline characteristics, lesion evolution and relation with PML-IRIS. J Neurol Neurosurg Psychiatry. 2018;89:535-41. DOI: https://doi.org/10.1136/jnnp-2017-316886
Scarpazza C, Signori A, Cosottini M, Sormani MP, Gerevini S, Capra R. Should frequent MRI monitoring be performed in natalizumabtreated MS patients? A contribution to a recent debate. Mult Scler. 2020;26:1227-36. DOI: https://doi.org/10.1177/1352458519854162
Igra MS, Paling D, Wattjes MP, Connolly DJ, Hoggard N. Multiple sclerosis update: use of MRI for early diagnosis, disease monitoring and assessment of treatment related complications. Br J Radiol. 2017;90:20160721. DOI: https://doi.org/10.1259/bjr.20160721
Bellanger G, Biotti D, Patsoura S, Ciron J, Ferrier M, Gramada R, et al. What is the relevance of the systematic use of gadolinium during the mri follow-up of multiple sclerosis patients under natalizumab? Clin Neuroradiol. 2020;30:553-8. DOI: https://doi.org/10.1007/s00062-019-00794-0
McGuigan C, Craner M, Guadagno J, Kapoor R, Mazibrada G, Molyneux P, et al. Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group. J Neurol Neurosurg Psychiatry. 2016;87:117-25. DOI: https://doi.org/10.1136/jnnp-2015-311100
Rovira A, Auger C, Huerga E, Corral JF, Mitjana R, Sastre-Garriga J, et al. Cumulative dose of macrocyclic gadolinium-based contrast agent improves detection of enhancing lesions in patients with multiple sclerosis. AJNR Am J Neuroradiol. 2017;38:1486-93. DOI: https://doi.org/10.3174/ajnr.A5253
Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, et al. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol. 2020;47:250-8. DOI: https://doi.org/10.1016/j.neurad.2020.01.083
Traboulsee A, Létourneau-Guillon L, Freedman MS, O’Connor PW, Bharatha A, Chakraborty S, et al. Canadian expert panel recommendations for mri use in ms diagnosis and monitoring. Can J Neurol Sci. 2015;42:159-67. DOI: https://doi.org/10.1017/cjn.2015.24
Vågberg M, Axelsson M, Birgander R, Burman J, Cananau C, Forslin Y, et al. Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society. Acta Neurol Scand. 2017;135:17-24. DOI: https://doi.org/10.1111/ane.12667
The Consortium of Multiple Sclerosis Centers. Revised Guidelines of the consortium of MS centers MRI protocol for the diagnosis and follow-up of MS. 2018. [cited 2022 May 20]. Available from: https://www.mscare.org/page/MRI_protocol.
Brisset JC, Vukusic S, Cotton F. Update on brain MRI for the diagnosis and follow-up of MS patients. Presse Med. 2021;50:104067. DOI: https://doi.org/10.1016/j.lpm.2021.104067
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