Multiple sclerosis diagnosis: magnetic resonance imaging compared with other instrumental examinations

Examination by magnetic resonance imaging (MRI), evoked potentials (EP) and cerebrospinal fluid (CSF) analyses was carried out on 97 definite, 20 probable and 40 possible multiple sclerosis (MS) patients (McAlpine's clinical criteria). MRI of only 4 transverse brain sections at the level of the ventricles and the analysis of the first 4 echoes showed periventricular or parenchymal lesions, or both, in 114 of the 117 definite and probable MS, and in 25 of the possible MS. MRI was more sensitive than the CSF analyses or EP; abnormalities more frequently appeared in known MS, and clinically asymptomatic lesions were seen. The MRI abnormalities were not, however, MS-specific; they were present in other neurological patients; none posed a question of differential diagnosis from MS. Complementary examinations, and especially MRI, should be a valuable adjunct for MS diagnosis, as long as the findings are viewed in the clinical context.