Ring-enhancement in multiple sclerosis: marker of disease severity

Correlations between conventional MRI measures of disease activity and clin ical disability in multiple sclerosis (MS) have been disappointing. Because ring-enhancing lesions may reflect a more destructive pathology, we tested their potential association with disease severity. We evaluated active les ions with regard to their enhancement pattern on serial magnetic resonance images in a cohort of 28 patients with relapsing-remitting MS. The percenta ge of ring-enhancing lesions correlated with EDSS T2 lesion load and durati on of disease and predicted the occurrence of relapses during the baseline period of observation as well as after 3 years of follow-up in multiple log istic regression analysis. The findings suggest that the Pathological proce ss reflected by ring-enhancing lesions may contribute to more severe clinic al disease.