A Single, Early Magnetic Resonance Imaging Study in the Diagnosis of Multiple Sclerosis

Rovira, Àlex; Swanton, JK; Tintoré, Mar; Huerga, Elena Charro; Barkhof, Frederik; Filippi, Massimo; Frederiksen, Jette Lautrup; Langkilde, Annika Reynberg; Miszkiel, Katherine; Polman, Chris H.; Rovaris, Marco; Sastre‐Garriga, Jaume; Miller, David H.; Montalbán, Xavier

doi:10.1001/archneurol.2009.49

Cited by 122 publications

(72 citation statements)

References 27 publications

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“…This revised version increased the sensitivity of the critieria and simplified the features of both DIS and DIT, while maintaining the specifi city of the earlier 2001 and 2005 versions of the criteria (Table 1). 7,[11][12][13][14] The benefits of the 2010 McDonald MRI criteria included the focus on lesion location rather than lesion count, which facilitates MRI interpretation; the elimination of a mandatory interval between the clinical attack and baseline reference scan (which had been arbitrarily determined), thereby facilitating management of patients; and the acceptance of the concomitant presence of gadolinium-enhancing and gadolinium-nonenhancing lesions as evidence for DIT, which allows very early diagnosis in some patients who undergo a single MRI examination at any time after symptom onset.…”

Section: Discussionmentioning

confidence: 99%

“…18 Thus, the diagnosis of PPMS can be challenging, particularly in patients with normal brain MRI and inconclusive spinal cord findings. [11][12][13]19,20 but the International Panel considered that the new criteria were also applicable to the diagnosis of MS in other populations (for example, paediatric patients, people of Asian ancestry, and Latin Americans). However, the Panel emphasized the need to confirm this view through additional studies in these populations.…”

Section: Discussionmentioning

confidence: 99%

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MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

et al. 2015

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| The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

et al. 2015

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“…In older patients ($12 years of age), it can be met at the time of a baseline scan provided there is evidence of both a gadolinium-enhancing and nonenhancing clinically silent lesion, based on prior work showing that the presence of nonenhancing and asymptomatic gadolinium-enhancing lesions is predictive for the development of RRMS in the setting of a first clinical attack. 5,6 New lesions on serial scans, or further clinical attacks, are also sufficient for MS diagnosis in patients not meeting criteria at the time of their incident attack and serial clinical and MRI evaluations are advised when confirming the diagnosis of MS in patients with onset age younger than 12 years.…”

Section: Role Of Mri In Ms Diagnosismentioning

confidence: 99%

MRI in the evaluation of pediatric multiple sclerosis

et al. 2016

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MRI plays a pivotal role in the diagnosis of multiple sclerosis (MS) in children, as it does in adults. The presence of multiple lesions in CNS locations commonly affected by MS, along with the presence of both enhancing and nonenhancing lesions, can facilitate a diagnosis of MS at the time of a first attack, whereas the accrual of serial lesions or new clinical attacks over time confirms the diagnosis in patients not meeting such criteria at onset. T2 and enhancing lesion accrual could serve as a primary outcome metric for pediatric MS clinical trials of selected therapies with anti-inflammatory activity in order to facilitate feasible trial size numbers. More-advanced MRI techniques reveal the impact of MS on tissue integrity within both T2-bright and T1-hypointense lesions and regions of normal-appearing tissue. Volumetric MRI analyses quantify the impact of MS on age-expected brain growth, and fMRI reveals activation and resting-state functional connectivity patterns in patients with pediatric MS that differ from those seen in healthy age-matched youth. Such studies are of critical importance because MS onset during childhood may profoundly influence maturing and actively myelinating neural networks. Highfield MRI visualizes MS pathology at a near-microscopic level and has the potential to more fully explain mechanisms for cognitive impairment, fatigue, and disability in patients with pediatric MS. Multiple sclerosis (MS) in childhood and adolescence is characterized by both clinical and MRI evidence of highly active inflammation. Although many aspects of relapsing-remitting MS (RRMS) are similar in both pediatric-and adult-onset disease, very young pediatric patients have certain unique features. Disorders to consider in the differential diagnosis of MS include non-MS inflammatory diseases, CNS involvement in systemic inflammatory disorders, and genetic and metabolic disorders of white matter, some of which have an associated inflammatory response. MRI forms a key component in evaluation. Pediatric-onset MS also provides a window into understanding the earliest biological aspects of MS. The disease has a great impact on brain integrity, as evidenced by MRI metrics that quantify disruption of tissue microstructure as well as loss of age-expected brain volume. The present article focuses on recent advances in neuroimaging in pediatric MS, with practical considerations for the use of MRI in diagnosis, monitoring of clinical course, and response to therapy. Potential advanced imaging techniques to further understand the impact of the disease on the ongoing maturing CNS are discussed, as is the utility of MRI as an outcome measure for clinical trials in pediatric MS. ROLE OF MRI IN MS DIAGNOSISConsiderable recent effort has focused on the contributions of MRI for distinguishing children with MS from children with monophasic demyelination. Other articles in this supplement provide details regarding the clinical features of incident demyelination, including acute disseminated From The Children's

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“…Instead, here we propose the use of predictive multivariate models that can generalise to unseen subjects (those not used to learn the parameters of a model) and thus potentially lead to a new imaging-based marker for MS. Recent work has highlighted the feasibility of using single structural scans for reliable MS diagnosis (Rovira et al, 2009), the ability of local multivariate predictive methods to discriminate between MS patients and controls with high accuracy, even when using NABT structural data (Weygandt et al, 2011), and the possibility of using global multivariate methods with structural data to distinguish various aspects of MS severity (Bendfeldt et al, 2012). Accordingly, given the increased use and development of predictive modelling techniques in fMRI research, originally derived from machine learning or pattern recognition (Kamitani and Tong, 2005;Mourao-Miranda et al, 2005;Ethofer et al, 2009;Weil and Rees, 2010;Shirer et al, 2011), it would appear highly suitable and advantageous to apply similar techniques to characterise high-dimensional fMRI data obtained during restingstate (Richiardi et al, 2010(Richiardi et al, , 2011.…”

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confidence: 99%

Classifying minimally disabled multiple sclerosis patients from resting state functional connectivity

et al. 2012

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A Single, Early Magnetic Resonance Imaging Study in the Diagnosis of Multiple Sclerosis

Cited by 122 publications

References 27 publications

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

MRI in the evaluation of pediatric multiple sclerosis

Classifying minimally disabled multiple sclerosis patients from resting state functional connectivity

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