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Magnetic Resonance Imaging of Asians with Multiple Sclerosis was Similar to that of the West

Published online by Cambridge University Press:  02 December 2014

H.T. Chong ,
N. Ramli ,
K.H. Lee ,
B.J. Kim ,
M. Ursekar ,
K. Dayananda ,
B.S. Singhal ,
J. Chong ,
L.L. Chan  and
Y.Y. Seetoh
...Show all authors
H.T. Chong*
Affiliation:
University of Malaya, Sungkyunkwan University School of Medicine, Seoul, Korea
N. Ramli
Affiliation:
University of Malaya, Sungkyunkwan University School of Medicine, Seoul, Korea
K.H. Lee
Affiliation:
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
B.J. Kim
Affiliation:
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
M. Ursekar
Affiliation:
Jankharia Neuroimaging Center, Bombay, India
K. Dayananda
Affiliation:
Mumbai, Bombay Hospital Institute of Medical Sciences, Bombay, India
B.S. Singhal
Affiliation:
Mumbai, Bombay Hospital Institute of Medical Sciences, Bombay, India
J. Chong
Affiliation:
National University of Singapore, Singapore
L.L. Chan
Affiliation:
Singapore General Hospital, Singapore
Y.Y. Seetoh
Affiliation:
National Neuroscience Institute, Singapore
O. Chawalparit
Affiliation:
Siriraj Hospital, Bangkok, Thailand
N. Prayoonwiwat
Affiliation:
Siriraj Hospital, Bangkok, Thailand
F.C. Chang
Affiliation:
Veterans General Hospital, Taipei, Taiwan
C.P. Tsai
Affiliation:
Veterans General Hospital, Taipei, Taiwan
P.C.K. Li
Affiliation:
Queen Elizabeth Hospital, Hong Kong
C.T. Tan
Affiliation:
University of Malaya, Sungkyunkwan University School of Medicine, Seoul, Korea
*
Neurology Laboratory, University of Malaya Medical Centre, 59100 Kuala Lumpar, Malaysia
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Abstract:

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Magnetic resonance imaging (MRI) of the brain is the most important paraclinical diagnostic test in multiple sclerosis (MS). The appearance of MRI in Asians with MS is not well defined. We retrospectively surveyed the first brain and spinal cord MRI in patients diagnosed to have MS, according to Poser's criteria in seven regions throughout Asia to define the MRI changes among Asians with MS. There were 101 patients with first brain, and 86 with first spinal cord MRI, 66 of whom had both. The brain MRI showed a mean of 17 lesions per patient in T2 weighted images, mostly asymptomatic. Almost all the lesions were in the white matter, particularly in the juxtacortical, deep and periventricular white matter. A third of the lesions were greater than 5 mm, 14% enhanced with gadolinium. There were more supratentorial than infratentorial lesions at a ratio of 7.5: 1. Ninety five percent of the spinal cord lesions were in cervical and thoracic regions, 34% enhanced with gadolinium. The lesions extended over a mean of 3.6 ± 3.3 vertebral bodies in length. Fifty (50%) of the brain and 54 (63%) of the spinal MRI patients had the optic-spinal form of MS. The MRI of the optic-spinal and classical groups of patients were similar in appearance and distribution, except that the optic-spinal MS patients have fewer brain but longer and more severe spinal cord lesions. In conclusion, the brain and spinal cord MRI of Asian patients with MS was similar to that of the West, although, in this study, Asian MS patients had larger spinal cord lesions.

Résumé

RÉSUMÉ

L'imagerie par résonance magnétique (IRM) du cerveau est l'épreuve diagnostique paraclinique la plus importante dans la sclérose en plaques (SEP). Les caractéristiques de l'IRM chez les Asiatiques atteints de SEP sont mal connues. Nous avons analysé rétrospectivement l'IRM initiale du cerveau et de la moelle épinière chez des patients dont le diagnostic de SEP avait été fait selon les critères de Poser dans sept régions d'Asie, afin de préciser les changements observés à l'IRM chez des Asiatiques atteints de SEP. L'imagerie du cerveau était disponible chez 101 patients, celle de la moelle épinière chez 86 patients et celle du cerveau et de la moelle épinière chez 66 patients. À l'IRM du cerveau, le nombre moyen de lésions par patient était de 17 sur les images pondérées en T2, ces lésions étant en grande partie asymptomatiques. Presque toutes les lésions étaient situées dans la substance blanche, surtout juxtacorticale, profonde et périventriculaire. Le tiers des lésions étaient de plus de 5 mm et 14% étaient rehaussantes à l'examen avec gadolinium. Il y avait plus de lésions sus-tentorielles que sous-tentorielles, pour un ratio de 7,5 à 1. Quatre-vingt-quinze pour cent des lésions de la moelle épinière étaient dans la région cervicale et la région thoracique et 34% étaient rehaussantes à l'examen avec gadolinium. Les lésions s'étendaient en moyenne sur une longueur correspondant à 3,6 ± 3,3 corps vertébraux. Cinquante patients (50%) ayant subi une IRM du cerveau et 54 patients (64%) ayant subi une IRM de la moelle épinière avaient une forme optique et spinale de la SEP. À l'IRM, l'apparence et la distribution des lésions des groupes optique-spinal et classique étaient semblables sauf que les patients atteints de la forme optique-spinale avaient moins de lésions cérébrales et des lésions plus longues et plus sévères à la moelle épinière. L'IRM du cerveau et de la moelle épinière.

Type
Exchange Article
Information
Canadian Journal of Neurological Sciences , Volume 33 , Issue 1 , February 2006 , pp. 95 - 100
Copyright
Copyright © The Canadian Journal of Neurological 2006

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