MRI Lesion Features and Distribution for MS Diagnosis

Experts provide recommendations on applying MRI in patients with typical demyelinating syndromes and atypical neurologic symptoms.

Experts convened in 2018 to discuss key imaging features for the correct interpretation and classification of lesions in multiple sclerosis (MS). They identified lesion characteristics and patterns of distribution as green flags for typical MS, in addition to lesions not specific to MS (so-called red flags). Among the highlights:

McDonald criteria should be most readily applied in a typical demyelination syndrome occurring in patients aged 18 to 50 years.
In addition to lesion number, consider size, shape, orientation, pattern of enhancement, and presence of a T1 hypointensity.
Spinal cord imaging should be considered as part of the work-up.
Gadolinium enhancement should last 1 to 2 months; persistent enhancement is a red flag.
Periventricular l…

Reviewing Author

Robert T. Naismith, MD

Disclosures

Consultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics

Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense

Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)

Robert T. Naismith, MD

Disclosures

Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense

Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)

MRI Lesion Features and Distribution for MS Diagnosis

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Reviewing Author