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Unenhanced and enhanced magnetic resonance imaging in the diagnosis of multiple sclerosis

F Fazekas1, F Barkhof, M Filippi

  • 1Department of Neurology and MR Center, Karl-Franzens University, Graz, Austria. franz.fazekas@kfunigraz.ac.at

Journal of Neurology, Neurosurgery, and Psychiatry
|July 1, 1998
PubMed

Insights

Magnetic resonance imaging (MRI) is crucial for diagnosing multiple sclerosis (MS). Specific lesion patterns and spinal imaging enhance diagnostic accuracy, helping differentiate MS from other conditions.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Initial enthusiasm for MRI in multiple sclerosis (MS) diagnosis waned due to non-specific lesions and lesion dissemination in non-MS patients.
  • Identifying the etiology of single hyperintensities remains challenging.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in multiple sclerosis (MS) diagnosis.
  • To identify specific MRI features that improve diagnostic accuracy for MS.
  • To assess the utility of spinal MRI in conjunction with brain MRI for MS diagnosis.

Main Methods:

  • Analysis of MRI features, including lesion distribution (periventricular, infratentorial, juxtacortical, corpus callosum involvement).
  • Evaluation of contrast enhancement patterns indicating lesion age (old vs. new).
  • Assessment of spinal MRI for intramedullary signal abnormalities and lesion detection.

Main Results:

  • Specific MRI characteristics, when combined, yield high diagnostic accuracy for MS.
  • Lesion distribution and contrast enhancement patterns are key diagnostic indicators.
  • Spinal MRI enhances sensitivity for detecting multiple lesions, even with equivocal brain MRI findings.

Conclusions:

  • MRI is the primary diagnostic tool for evaluating multiple sclerosis (MS) due to its high sensitivity to plaques.
  • Combined analysis of brain and spinal MRI findings, including lesion characteristics, improves diagnostic confidence.
  • MRI facilitates the exclusion of other neurological conditions with gross morphological damage.

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