The Prognostic Utility of MRI in Clinically Isolated Syndrome: A Literature Review

Odenthal, Cara; Coulthard, Alan

doi:10.3174/ajnr.a3954

Cited by 17 publications

(14 citation statements)

References 95 publications

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“…There are literature reviews on MRI factors and their association with the risk of developing MS following a CIS; however, most do not fulfil systematic review criteria . To the best of our knowledge, no systematic review has assessed the prognostic value of MRI for disability following a CIS.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review

et al. 2018

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Magnetic resonance imaging (MRI) is the key prognostic tool in people with a clinically isolated syndrome (CIS). There is increasing interest in treating people following a CIS in the hope that conversion to multiple sclerosis (MS) will be prevented and future disability reduced. So far, the prognostic value of MRI for disability following a CIS has not been evaluated systematically. We systematically searched MEDLINE and EMBASE. Cohort studies were selected if they reported associations of MRI and disability following a CIS, included at least 50 people with a CIS at baseline, had at least 5 years of follow-up and obtained at least one structural MRI measurement (T1 lesions, T2 lesions, T1 contrast-enhancing lesions or brain atrophy). We assessed the studies for quality and rated the completeness of MRI reporting. In total, 13 studies were identified reporting on the following: T2 lesion number and volume, T2 infratentorial lesion number and volume, T1 contrast-enhancing lesions and grey matter fraction. T2 brain lesion number determined soon after the occurrence of a CIS was associated with disability progression after 5-7 years, with an increased risk when 10 or more lesions were present. Infratentorial lesions were also associated with a higher risk of subsequent disability. The number and distribution of MRI-visible lesions soon after a CIS are associated with disability later on, and may offer additional useful information when making treatment decisions in people with early MS. Further work is required to determine whether other measures have a higher predictive potential.

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Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review

et al. 2018

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“…Myelin reflects a very high density of bilayers that are formed by wrapping of oligodendrocyte cell membranes around axons (1). Given that myelin is essential for rapid conduction of nerve impulses and damage to myelin can occur in trauma (2), multiple sclerosis (MS) (3), and other disorders, a sensitive and specific measure of myelin and its properties would be a potentially important clinical and research tool (4,5). Studies of white matter (WM) pathology using simple metrics of MT, such as the MT ratio (MTR), have shown some promise (6), but detailed studies suggest that sensitivity to factors other than myelin reduces diagnostic specificity of MTR (7).…”

Section: Introductionmentioning

confidence: 99%

In vivo measurement of a new source of contrast, the dipolar relaxation time, T_1D, using a modified inhomogeneous magnetization transfer (ihMT) sequence

Varma

Girard

Prevost

et al. 2016

Magnetic Resonance in Med

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“…29 Estas técnicas avançadas de RM têm contribuído sobretudo para um melhor entendimento da fisiopatologia da EM. 29,30 As limitações desta revisão são aquelas inerentes aos estudos incluídos. Coortes pequenas, critérios de seleção heterogéneos e tempos de seguimento curtos limitam a generalização das conclusões dos estudos.…”

Section: Discussionunclassified

“…29,30 A espectroscopia quantifica diferentes metabolitos num determinado voxel. 29 Estes metabolitos são altamente específicos: o N--acetilaspartato é marcador de integridade neuronal, a colina está associada à mielina e o mio-inositol encontra-se primariamente em células gliais.…”

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“…29 Estes metabolitos são altamente específicos: o N--acetilaspartato é marcador de integridade neuronal, a colina está associada à mielina e o mio-inositol encontra-se primariamente em células gliais. 14,29,30 Num estudo com 142 doentes com SCI, que se manifestou por nevrite ótica, seguidos durante cinco anos, nenhuma das medidas de MTI e espectroscopia modificaram significativamente o risco de conversão para EM.…”

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Alterações na Ressonância Magnética Preditoras da Conversão da Síndrome Clinicamente Isolada em Esclerose Múltipla

Peixoto

Abreu

2016

Acta Med Port

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RESUMOIntrodução: A síndrome clinicamente isolada é uma forma de apresentação da esclerose múltipla, doença desmielinizante crónica do sistema nervoso central, e define-se por um único episódio clínico sugestivo de desmielinização. Porém, doentes com esta síndrome podem não desenvolver novos sintomas ou lesões, mesmo após longos períodos de seguimento, não cumprindo os critérios de diagnóstico da doença. Aqui serão revistas, na síndrome clinicamente isolada, as alterações na ressonância magnética que melhor predizem a conversão em esclerose múltipla. Material e Métodos:Pesquisaram-se na base de dados da PubMed artigos publicados entre janeiro de 2010 e junho de 2015 usando os termos 'clinically isolated syndrome', 'cis', 'multiple sclerosis', 'magnetic resonance imaging', 'magnetic resonance' e 'mri'.Resultados: Carga lesional, localização das lesões, critérios de Barkhof e áreas/volumes de estruturas cerebrais foram as alterações na ressonância magnética convencional encontradas nos artigos incluídos nesta revisão. As técnicas não convencionais estudadas foram a dupla inversão-recuperação, a transferência de magnetização, a espectroscopia e a imagem de tensor de difusão.Discussão: Enquanto o número de lesões e a sua localização têm um papel claro na previsão da conversão da síndrome clinicamente isolada em esclerose múltipla, as técnicas não convencionais e as restantes alterações na ressonância magnética necessitam de mais estudos para confirmar a sua capacidade de prever o desenvolvimento da doença.Conclusão: Para além do valor preditivo das alterações já citadas, no futuro, diferentes achados neurorradiológicos na síndrome clinicamente isolada poderão ser considerados para os critérios de diagnóstico da esclerose múltipla e/ou modificar as recomendações sobre o seu tratamento. Palavras-chave: Doenças Autoimunes Desmielinizantes do Sistema Nervoso Central; Esclerose Múltipla; Prognóstico; RessonânciaMagnética. ABSTRACT Introduction:Clinically isolated syndrome may be the first manifestation of multiple sclerosis, a chronic demyelinating disease of the central nervous system, and it is defined by a single clinical episode suggestive of demyelination. However, patients with this syndrome, even with long term follow up, may not develop new symptoms or demyelinating lesions that fulfils multiple sclerosis diagnostic criteria. We reviewed, in clinically isolated syndrome, what are the best magnetic resonance imaging findings that may predict its conversion to multiple sclerosis. Material and Methods:A search was made in the PubMed database for papers published between January 2010 and June 2015 using the following terms: 'clinically isolated syndrome', 'cis', 'multiple sclerosis', 'magnetic resonance imaging', 'magnetic resonance' and 'mri'. Results:In this review, the following conventional magnetic resonance imaging abnormalities found in literature were included: lesion load, lesion location, Barkhof's criteria and brain atrophy related features. The non conventional magnetic resonance imaging techniques studie...

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The Prognostic Utility of MRI in Clinically Isolated Syndrome: A Literature Review

Cited by 17 publications

References 95 publications

Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review

Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review

In vivo measurement of a new source of contrast, the dipolar relaxation time, T_1D, using a modified inhomogeneous magnetization transfer (ihMT) sequence

Alterações na Ressonância Magnética Preditoras da Conversão da Síndrome Clinicamente Isolada em Esclerose Múltipla

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The Prognostic Utility of MRI in Clinically Isolated Syndrome: A Literature Review

Cited by 17 publications

References 95 publications

Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review

Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review

In vivo measurement of a new source of contrast, the dipolar relaxation time, T1D, using a modified inhomogeneous magnetization transfer (ihMT) sequence

Alterações na Ressonância Magnética Preditoras da Conversão da Síndrome Clinicamente Isolada em Esclerose Múltipla

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In vivo measurement of a new source of contrast, the dipolar relaxation time, T_1D, using a modified inhomogeneous magnetization transfer (ihMT) sequence