MRI criteria for MS in patients with clinically isolated syndromes

University of Milan, Milano, Lombardy, Italy
Neurology (Impact Factor: 8.29). 02/2010; 74(5):427-34. DOI: 10.1212/WNL.0b013e3181cec45c
Source: PubMed


In recent years, criteria for the diagnosis of multiple sclerosis (MS) have changed, mainly due to the incorporation of new MRI criteria. While the new criteria are a logical step forward, they are complex and-not surprisingly-a good working knowledge of them is not always evident among neurologists and neuroradiologists. In some circumstances, several MRI examinations are needed to achieve an accurate and prompt diagnosis. This provides an incentive for continued efforts to refine the incorporation of MRI-derived information into the diagnostic workup of patients presenting with a clinically isolated syndrome. Within the European multicenter collaborative research network that studies MRI in MS (MAGNIMS), a workshop was held in London in November 2007 to review information that may simplify the existing MS diagnostic criteria, while maintaining a high specificity that is essential to minimize false positive diagnoses. New data that are now published were reviewed and discussed and together with a new proposal are integrated in this position paper.

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Available from: Jette Frederiksen, Nov 11, 2014
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    • "For CIS, on T2-weighted MRI, 50–70% of adults show white matter brain lesions, suggesting demyelination [2]. The McDonald criteria used for the diagnosis of MS applies to typically presenting cases of CIS, yet its utility in atypical presentations has not been determined [3,14]. It has been reported that in a patient with suspected CIS, the presence of abnormal lesions on a T2-weighted MRI may predict a long-term 60–80% risk for clinically definite MS [2]. "
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    ABSTRACT: Background There are several categories of primary inflammatory demyelinating disorders, which comprise clinically similar neurologic sequelae. Of interest, clinically isolated syndrome (CIS) and acute disseminated encephalomyelitis (ADEM) are 2 demyelinating conditions of the central nervous system (CNS), whose clinical similarity pose a significant challenge to definitive diagnosis. Yet, both remain important clinical considerations in patients with neurologic signs and symptoms in the context of recent vaccination. Case Report We report a case of a 50-year-old Caucasian male with a course of progressive, focal, neurologic deficits within 24 h after receiving the influenza vaccine. Subsequent work-up revealed the possibility of an acute central nervous system (CNS) demyelinating episode secondary to the influenza vaccine, best described as either CIS or ADEM. Conclusions Case reports of CNS demyelination following vaccinations have been previously noted, most often occurring in the context of recent influenza vaccination. This report serves to document a case of CNS demyelination occurring 24 h after influenza vaccination in a middle-aged patient, and will describe some salient features regarding the differential diagnosis of CIS and ADEM, as well as their potential management.
    American Journal of Case Reports 08/2014; 15:368-373. DOI:10.12659/AJCR.891416
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    • "Magnetic resonance sequences included conventional T1-weighted imaging, T2-weighted imaging, fluid-attenuated inversion recovery (FLAIR) sequence and diffusion-weighted imaging (DWI). The MRI diagnostic criteria for MS were those recommended in the European Magnetic Resonance Imaging in MS (MAGNIMS) proposal [14]. This required intravenous administration of a gadolinium-containing MR contrast agent, such as gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA), followed by dynamic contrast-enhanced MR imaging (DCE-MRI) of the brain or spinal cord. "
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    ABSTRACT: Reports in Asian populations suggest that ethnic and geographical differences may influence susceptibility to multiple sclerosis (MS) and its clinical behaviors. Here, we sought to retrospectively survey clinical characteristics and MRI data in Chinese subjects with MS. We conducted a retrospective analysis in 117 patients with MS. The patients were divided into subgroups with optic-spinal form of multiple sclerosis (OSMS; n = 42) and classical multiple sclerosis (CMS; n = 75). Clinical characteristics, MRI finding and expanded disability status scale (EDSS) score were compared between the two groups. In 117 MS patients, 64.1% patients were classified as having CMS and 35.9% OSMS forms. White blood cell counts of OSMS patients were significantly higher than those of CMS patients (P <0.05). The longitudinal fusion lesions of spinal cord on MRI were statistically significant between groups (P <0.05). Spinal cord MRI showed that MS lesions were longer, and revealed spinal cord swelling in patients with CMS, but atrophy in patients with OSMS. The EDSS score at five years was significantly higher in patients with OSMS than in those with CMS (P <0.05). Relapse rates of patients with OSMS were also higher than those of patients with CMS (P <0.01) within one to three years. OSMS accounts for a higher proportion of MS populations in Northern China than in Western countries. MRI showed a longitudinally extensive spinal cord lesion in patients with OSMS and spinal cord swelling at onset.
    04/2014; 19(1):20. DOI:10.1186/2047-783X-19-20
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    • "Even though definite diagnosis of MS is clinical, early radiologic confirmation is very important in patient management and, therefore, imaging criteria need continuous updating (Montalban et al., 2010). MRI brain images obtained from patients with MS may depict lesions that resemble brain lesions from other diseases such as inflammatory disorders or cerebrospinal disease (Bot et al., 2002; Lou et al., 2009; Trojano, 2011; Zhang, 2012). "
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    ABSTRACT: The aim of this study was to employ state-of-art graphics processing unit (GPU) technology and CUDA parallel programming to design and implement a stand-alone pattern recognition (PR) system to discriminate between patients with micro-ischaemic (mIS) and multiple sclerosis (MS) lesions. The dataset comprised MRI image series of 32 patients with mIS and 19 with MS lesions. The probabilistic neural network classifier and 40 textural features, calculated from lesions in the magnetic resonance imaging (MRI) images, were used to design the PR system. The highest classification accuracy was 90.2%, employing six textural features. It took about 135 minutes to design the PR system on a desktop CPU (Intel Core 2 Quad Q9550), using sequential programming, against 250 seconds on the Nvidia 8800GT GPU card, using parallel programming. The proposed PR system may be redesigned on site, when new verified data are incorporated in its depository, and it may serve as a second opinion tool in a clinical environment.
    International Journal of High Performance Computing Applications 08/2013; 27(3):348-359. DOI:10.1177/1094342012464253 · 1.48 Impact Factor
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