Spinal cord MRI in clinically isolated optic neuritis

Area of Science:

• Neuroimaging
• Neurology
• Clinical Diagnosis

Background:

• Clinically isolated optic neuritis (ON) is an initial presentation of demyelinating diseases.
• Early diagnosis is crucial for timely intervention and management of neurological conditions.

Purpose of the Study:

• To evaluate the diagnostic utility of spinal cord magnetic resonance imaging (MRI) in patients with clinically isolated optic neuritis.
• To assess the contribution of spinal cord imaging to the diagnosis of multiple sclerosis (MS) based on established criteria.

Main Methods:

• One hundred and fifteen patients with clinically isolated optic neuritis underwent brain and spinal cord MRI within three months of symptom onset.
• Analysis included the presence and number of brain lesions and cord lesions.
• Diagnostic criteria for MS were applied to assess the impact of MRI findings.

Main Results:

• Brain lesions were detected in 70% of patients, while cord lesions were found in 27%.
• The likelihood of cord lesions increased with the number of brain lesions (12% with normal brain MRI to 45% with ≥9 brain lesions).
• Spinal cord imaging contributed to diagnosing MS in only a small number of additional asymptomatic patients over three years.

Conclusions:

• Spinal cord imaging has limited value in diagnosing multiple sclerosis in patients presenting with clinically isolated optic neuritis under existing criteria.
• Brain MRI is more informative in identifying lesions suggestive of demyelination in this patient cohort.
• Further research may be needed to refine diagnostic criteria for early MS detection.