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Central nervous system infectious diseases mimicking multiple sclerosis: recognizing distinguishable features using

Antônio José da Rocha1, Ingrid Aguiar Littig, Renato Hoffmann Nunes

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Magnetic resonance imaging (MRI) aids multiple sclerosis (MS) diagnosis by showing lesion dissemination. Differentiating MS from mimics, especially infectious diseases, requires careful evaluation of MRI features and clinical data.

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Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Magnetic resonance imaging (MRI) is crucial for diagnosing multiple sclerosis (MS), enabling assessment of dissemination in space (DIS) and time (DIT) in a single scan.
  • Maintaining diagnostic specificity requires differentiating MS from conditions with similar MRI features.
  • Infectious diseases are a key differential diagnosis for MS, presenting with overlapping clinical and imaging findings.

Purpose of the Study:

  • To review key imaging features of infectious diseases that mimic multiple sclerosis (MS).
  • To compare the lesion distribution and gadolinium enhancement patterns of MS with those of mimicking infectious diseases.
  • To highlight imaging "red flags" that aid in the differential diagnosis of suspected MS cases.

Main Methods:

  • Review of current literature on diagnostic criteria for MS.
  • Analysis of MRI characteristics (T2/FLAIR lesions, gadolinium enhancement) in MS and relevant infectious diseases.
  • Comparison of lesion spatial distribution and enhancement patterns between MS and differential diagnoses.

Main Results:

  • Certain infectious diseases present MRI features that can be mistaken for MS.
  • Distinct patterns in lesion location and gadolinium enhancement can help differentiate MS from mimics.
  • Identifying specific imaging "red flags" is essential for accurate diagnosis.

Conclusions:

  • Careful assessment of MRI findings, alongside clinical and laboratory data, is vital for accurate MS diagnosis.
  • Recognizing imaging mimics, particularly infectious diseases, improves diagnostic specificity.
  • The study emphasizes the importance of a comprehensive approach to differentiate MS from its mimics using MR imaging.