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Related Experiment Video

Updated: Mar 1, 2026

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Published on: April 14, 2014

ACR Appropriateness Criteria® Demyelinating Diseases.

, Aleks Kalnins¹, Lenora M Lewis²

¹University of Chicago, Chicago, Illinois.

Journal of the American College of Radiology : JACR

|February 28, 2026

Summary

Magnetic Resonance Imaging (MRI) is crucial for diagnosing central nervous system demyelinating diseases like multiple sclerosis (MS). Advanced MRI techniques and updated criteria improve diagnostic accuracy, differentiating between various conditions.

Keywords:

AUC Appropriate Use Criteria Appropriateness Criteria MRI central nervous system (CNS)demyelinating diseases inflammatory disorders multiple sclerosis (MS)neuromyelitis optica spectrum disorder (NMOSD)

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Area of Science:

Neurology
Radiology
Immunology

Background:

Demyelinating diseases, including multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and MOGAD, affect central nervous system myelin.
MRI is the primary imaging tool for detecting demyelinating lesions, surpassing CT in sensitivity.

Purpose of the Study:

To review the role of MRI in diagnosing and differentiating CNS demyelinating diseases.
To highlight advancements in MRI techniques and diagnostic criteria.

Main Methods:

Review of current literature on MRI in demyelinating diseases.
Analysis of the 2024 McDonald criteria and American College of Radiology Appropriateness Criteria.
Discussion of advanced MRI techniques (DTI, MTI, AI) and gadolinium enhancement patterns.

Main Results:

The 2024 McDonald criteria, incorporating features like the central vein sign, achieve 94% accuracy for MS diagnosis at 3T MRI.
Gadolinium enhancement patterns and lesion morphology on MRI help differentiate active from chronic lesions and distinguish between MS, NMOSD, and MOGAD.
Spinal cord MRI shows distinct lesion patterns: short peripheral in MS versus longitudinally extensive in NMOSD.

Conclusions:

MRI, particularly with advanced techniques and updated criteria, is essential for accurate diagnosis and differentiation of CNS demyelinating diseases.
Evidence-based guidelines and expert consensus are vital for standardizing imaging and treatment appropriateness.