The utility of MRI in suspected MS: report of the Therapeutics and technology assessment Subcommittee of the American Academy of Neurology

Frohman, EM; Goodin, D. S.; Calabresi, PA; Corboy, JR; Coyle, PK; Filippi, Marc; Frank, J. H.; Galetta, S. L.; Grossman, R I; Hawker, Kathleen; Kachuck, N.; Levin, MC; Phillips, J. Theodore; Racke, M.; Rivera, Victor M.; Wh, Stuart

doi:10.1016/j.ajo.2003.11.030

Cited by 41 publications

(56 citation statements)

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“…Neurologists in North America had treated these patients with immunomodulatory drugs without waiting for the evidence of disease DIT. 16,21 Using a single MRI in proving the DIT for patients with CIS had also been proposed, based on the argument that an asymptomatic gadolinium-enhanced or a T2-weighted lesion reflects different stages of evolution in the pathology of the lesion, hence proving DIT. 22 However, caution is needed when one makes the diagnosis of MS in patients who only fulfill the criteria of DIS alone, as the specificity and positive predictive values of these criteria are low when compared to those in which DIS with DIT or even DIT alone are fulfilled.…”

Section: Multiple Sclerosis and Mrimentioning

confidence: 99%

“…14 MRI has a superior capability to delineate intracranial lesions compared to CT scans, with excellent results of 90% to 97% from studies of clinically definite MS. For detection of clinically silent lesions and lesions associated with specific symptoms, MRI has been useful in early diagnosis and it gives evidence of DIS. 15,16 Several studies have examined the criteria used to predict the development of MS on MRI with variable sensitivity and specificity. Fazekas et al proposed criteria that required three or more lesions, two of which must be larger than 5 mm in diameter, which also must abut the bodies of the lateral ventricles; and there must be plaques in the infratentorial brain.…”

Section: Multiple Sclerosis and Mrimentioning

confidence: 99%

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The past, present and future of imaging in multiple sclerosis

Ramli

Rahmat

Azmi

et al. 2010

Journal of Clinical Neuroscience

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Section: Multiple Sclerosis and Mrimentioning

confidence: 99%

Section: Multiple Sclerosis and Mrimentioning

confidence: 99%

The past, present and future of imaging in multiple sclerosis

Ramli

Rahmat

Azmi

et al. 2010

Journal of Clinical Neuroscience

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“…The recent introduction of the McDonald criteria has further strengthened the role of MRI in the diagnosis of multiple sclerosis (MS) [1][2][3]. Since increased sensitivity for lesion detection may accelerate the definite diagnosis of MS and permit an earlier treatment [4], reliable lesion detection is desirable in patients with suspected MS.…”

Section: Introductionmentioning

confidence: 99%

FLAIR imaging for multiple sclerosis: a comparative MR study at 1.5 and 3.0 Tesla

et al. 2005

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The purpose of this study was (1) to identify the optimal TE for FLAIR-imaging at 3.0 T assessing three different echo times qualitatively and quantitatively and (2) to evaluate the diagnostic efficacy of high-field 3.0-T FLAIR imaging in comparison to conventional 1.5-T MRI in patients with multiple sclerosis (MS). Twenty-two patients with clinically definite MS underwent axial FLAIR imaging at 1.5 and 3.0 T. In 15 of these patients further FLAIR images with a TE of 100, 120 and 140 ms were acquired at 3.0 T. Imaging protocols were modified for 3.0 T using the increased SNR to acquire more and thinner slices while maintaining a comparable scan time. FLAIR images of either different TEs or different field strengths were ranked for each patient qualitatively by two observers. Signal intensity measurements were obtained in the gray and white matter, CSF and representative white matter lesions (WML). At 3.0 T, a TE of 100 and 120 ms proved superior in all qualitative categories when compared to 140 ms. In the quantitative assessment CNR of WML was highest for 120 ms (CNR: 19.8), intermediate for 100 ms (17.2) and lowest for 140 ms (15.3) (P<0.003). For lesion conspicuity and overall image quality, 3.0 T was judged superior to 1.5 T, whereas no difference was found for gray-white differentiation and image noise. With regard to artifacts, 3.0 T was inferior to 1.5 T. The CNR for WML was slightly lower at 3.0 T, but the difference was not significant (22.6 vs. 28.0, P=ns). However, significantly more WML were detected at 3.0 T than at 1.5 T (483 vs. 341, P<0.0001). The optimal echo time for FLAIR imaging at 3.0 T is 120 ms due to the significantly higher CNR of WML. By trading the higher SNR at 3.0 T for better spatial resolution, nearly the same CNR level could be maintained, increasing lesion detectability at 3.0 T compared to 1.5 T. Thus, high-field MRI may further strengthen the role of MRI as the most sensitive paraclinical test for the early diagnosis of MS.

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“…Patients with CIS by definition have had 1 apparent clinical attack, whereas patients with RR-MS are characterized by disease dissemination in time and space. A high proportion of CIS who present with brain magnetic resonance imaging (MRI) abnormalities will proceed to develop RR-MS, 27,28 and indeed, for many of those patients, subclinical MS or minor attacks may have been present for a considerable period. Thus it can be envisioned that detection of a-GalC antibodies may permit staging of MS forms according to time from the first demyelinating event.…”

Section: Discussionmentioning

confidence: 99%