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Background: After the resolution of contrast enhancement, the majority of new MS lesions become isointense with surrounding white matter on T1-weighted MRI. Less commonly, a hypointense T1 lesion develops, representing the development of more severe focal tissue damage. Interferon beta (IFNβ) reduces both the number of new enhancing lesions and the duration of contrast enhancement. Objective: To determine if IFNβ affects the degree of tissue damage within new lesions and if its effects are related to lesion size. Methods: One hundred twenty-five patients with secondary progressive MS from seven European sites were randomized to receive either IFNβ-1b or placebo. Monthly, contrast-enhanced T1-weighted MR images were acquired at baseline, at months 1 to 6, and at months 19 to 24. The size of all new enhancing lesions developing between months 1 and 6 was recorded and their appearance at follow-up documented. Results: In the first 6 months, fewer new enhancing lesions occurred in the IFNβ-1b arm. This difference was greater for small (70% decrease) than for large (46% decrease) lesions. Hypointense T1 lesions were more likely to form from large (25%) than from small (9%) enhancing lesions in both treatment arms. Patients taking IFNβ-1b developed fewer hypointense T1 lesions; however, the proportion of enhancing lesions developing into hypointense T1 lesions was similar in both arms. Conclusion: IFNβ-1b reduced the number of new enhancing lesions, with a greater effect on small lesions. However, when a new enhancing lesion did become established, treatment with IFNβ-1b did not alter its subsequent course.

A 23-year-old medical student presented with slowly progressive swelling of the terminal digits that had a duration of 3 years (Figure 1). Figure 1. Photograph of the patient’s left hand showing clubbing. There was no family history of clubbing or cyanosis. The patient had no signs of cyanosis or a history of cardiac, pulmonary, or …

Fifty-seven biopsy proven breast masses have been examined at our institution by magnetic resonance (MR), mammography, and ultrasound. The three techniques have been evaluated concerning their capability to visualize the lesion and the diagnostic information obtained. Magnetic resonance proved comparable to mammography and superior to sonography in the fatty to medium dysplastic breasts but inferior to the combined examination by mammography and sonography in the dense breasts. In some selected cases, however, special advantages of MR have been found.

In a preliminary study 20 patients underwent breast examinations by magnetic resonance (MR) imaging without and with Gd-DTPA as contrast medium. All carcinomas enhanced, whereas dysplastic tissue enhanced slightly or not at all. Significant additional diagnostic information was available on the Gd-DTPA examinations in at least four of 20 cases compared with MR without contrast medium and X-ray mammography. Our preliminary results indicate that MR imaging of breast using Gd-DTPA may be helpful for the evaluation of dense breasts and the differentiation of dysplasia and scar tissue from carcinoma.