MRI in the Diagnosis and Followup of Multiple Sclerosis

Magnetic Resonance Imaging (MRI) of the brain is useful in the diagnosis and treatment of multiple sclerosis (MS), because it is an inflammatory, demyelinating condition of the central nervous system (CNS) that MRI can visualize. Therefore, the activity of the disease can be quantified and tracked over time, with treatment. White matter tracts are affected, including those of the upper brain, lower brain, and spinal cord. MS lesions, known as plaques, may form in white matter in any location; thus, clinical symptoms may be diverse depending on where in the brain or spinal cord the disease is most active. MRI can identify the activity and explain the symptoms. MRI was widely used to in the diagnosis of multiple sclerosis (MS) and increasingly in follow-up. At the same time, it was not entirely clear how to use MRI. A consensus meeting was convened in 2008 to review and update the guidelines. The new guidelines incorporate new information and practice recommendations that will benefit patients and will be useful for physicians and care providers. This consensus recommends a for a baseline evaluation for patients with a Clinically Isolated Syndrome (CIS) and suspected MS.  A Brain MRI with gadolinium, a Spinal Cord MRI if there is persisting uncertainty about the diagnosis and/or the findings on Brain MRI are equivocal should be performed, as well as a Spinal Cord MRI if presenting symptoms or signs are at the level of the spinal cord.

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