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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Beyond McDonald: updated perspectives on MRI diagnosis of multiple sclerosis
Àlex Rovira1,2, Cristina Auger1,2
1Section of Neuroradiology (Department of Radiology), Hospital Universitari Vall d'Hebron, Universitat Autònoma De Barcelona, Barcelona, Spain.
Introduction:
Magnetic resonance imaging (MRI) is an essential paraclinical test to establish an accurate and early diagnosis of multiple sclerosis (MS), which is based on the application of the McDonald criteria.
Areas Covered:
The objective of this article is to analyze, based on publicly available database since the publication of the 2017 McDonald diagnostic criteria, the clinical impact of these criteria, to discuss the potential inclusion within these criteria of the optic nerve to demonstrate dissemination in space, and to guide the acquisition and interpretation of MRI scans for diagnostic purposes. Finally, the authors will review emerging MRI features that could improve the specificity of MRI in the diagnosis of MS and consequently minimize the misdiagnosis of this disease.
Expert Opinion:
Although the optic nerve has not been included as one of the topographies required to demonstrate demyelinating lesion disseminated in space in the 2017 McDonald criteria, new studies seem to show some improvement in the sensitivity of these criteria when this topography is considered. New radiological findings such as the central vein sign and iron rims, should be considered within the typical MRI features of this disease with the objective of minimizing MRI-based diagnostic errors.
Insights
Magnetic resonance imaging (MRI) aids multiple sclerosis (MS) diagnosis using McDonald criteria. Including the optic nerve and new MRI findings like the central vein sign may improve accuracy and reduce misdiagnosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Magnetic resonance imaging (MRI) is crucial for diagnosing multiple sclerosis (MS).
- The 2017 McDonald criteria guide MS diagnosis using MRI.
- Accurate and early diagnosis of MS is essential for effective management.
Purpose of the Study:
- Analyze the clinical impact of the 2017 McDonald criteria on MS diagnosis.
- Discuss the potential inclusion of the optic nerve in diagnostic criteria for dissemination in space.
- Review emerging MRI features to enhance diagnostic specificity and minimize misdiagnosis.
Main Methods:
- Review of publicly available databases post-2017 McDonald criteria publication.
- Analysis of the role of optic nerve involvement in demonstrating dissemination in space.
- Evaluation of novel MRI findings for improved MS diagnosis.
Main Results:
- The 2017 McDonald criteria are the current standard for MS diagnosis via MRI.
- Considering the optic nerve may improve the sensitivity of the McDonald criteria.
- Emerging MRI features like the central vein sign and iron rims show promise.
Conclusions:
- The optic nerve's inclusion could enhance MS diagnostic sensitivity.
- New MRI findings like central vein sign and iron rims may improve specificity.
- Optimizing MRI acquisition and interpretation is key to minimizing MS misdiagnosis.
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