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Multiple sclerosis: correlation of magnetic resonance imaging with cerebrospinal fluid findings
L S Honig1, R Siddharthan, W A Sheremata
1Department of Neurology, University of Miami School of Medicine, FL.
Abstract:
MRI examination of 41 patients with clinical definite multiple sclerosis showed white matter lesions of high proton T2 signal consistent with demyelination in 76% and CSF abnormalities present in 76%. Of patients with CSF abnormalities, 26% had normal MRI scans; conversely 26% of patients with MRI abnormalities had negative CSF studies. Thus a significant number of multiple sclerosis patients had negative results on either MRI or CSF examination, while only 5% had normal results on both tests.
Insights
Magnetic Resonance Imaging (MRI) and Cerebrospinal Fluid (CSF) tests are crucial for diagnosing multiple sclerosis (MS). However, a significant number of MS patients may have normal results on one test, highlighting the need for comprehensive diagnostic approaches.
Area of Science:
- Neurology
- Neuroimaging
- Clinical Diagnostics
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease.
- Diagnostic criteria for MS often involve clinical evaluation alongside imaging and laboratory tests.
- Magnetic Resonance Imaging (MRI) and Cerebrospinal Fluid (CSF) analysis are key diagnostic tools.
Purpose of the Study:
- To evaluate the diagnostic utility of MRI and CSF analysis in patients with clinically definite multiple sclerosis.
- To determine the concordance and discordance rates between MRI findings and CSF abnormalities in MS patients.
Main Methods:
- Retrospective analysis of MRI scans and CSF examination results from 41 patients.
- Patients were diagnosed with clinical definite multiple sclerosis.
- Assessment of white matter lesions (high proton T2 signal) on MRI and abnormalities in CSF.
Main Results:
- 76% of patients showed white matter lesions on MRI, indicative of demyelination.
- 76% of patients exhibited CSF abnormalities.
- A notable percentage of patients (26%) had normal MRI with CSF abnormalities, and vice versa (26% had MRI abnormalities with negative CSF studies).
Conclusions:
- Neither MRI nor CSF examination alone can definitively diagnose all cases of multiple sclerosis.
- A significant proportion of MS patients present with discordant results between MRI and CSF.
- Only 5% of patients had normal results on both MRI and CSF, underscoring the importance of considering both modalities and clinical context.