Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines

Massimo Filippi, Paolo Preziosa, Brenda L Banwell, Frederik Barkhof, Olga Ciccarelli, Nicola De Stefano, Jeroen J G Geurts, Friedemann Paul, Daniel S Reich, Ahmed T Toosy, Anthony Traboulsee, Mike P Wattjes, Tarek A Yousry, Achim Gass, Catherine Lubetzki, Brian G Weinshenker, Maria A Rocca

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

MRI has improved the diagnostic work-up of multiple sclerosis, but inappropriate image interpretation and application of MRI diagnostic criteria contribute to misdiagnosis. Some diseases, now recognized as conditions distinct from multiple sclerosis, may satisfy the MRI criteria for multiple sclerosis (e.g. neuromyelitis optica spectrum disorders, Susac syndrome), thus making the diagnosis of multiple sclerosis more challenging, especially if biomarker testing (such as serum anti-AQP4 antibodies) is not informative. Improvements in MRI technology contribute and promise to better define the typical features of multiple sclerosis lesions (e.g. juxtacortical and periventricular location, cortical involvement). Greater understanding of some key aspects of multiple sclerosis pathobiology has allowed the identification of characteristics more specific to multiple sclerosis (e.g. central vein sign, subpial demyelination and lesional rims), which are not included in the current multiple sclerosis diagnostic criteria. In this review, we provide the clinicians and researchers with a practical guide to enhance the proper recognition of multiple sclerosis lesions, including a thorough definition and illustration of typical MRI features, as well as a discussion of red flags suggestive of alternative diagnoses. We also discuss the possible place of emerging qualitative features of lesions which may become important in the near future.

Original languageEnglish
Pages (from-to)1858-1875
JournalBrain : a journal of neurology
Volume142
Issue number7
DOIs
Publication statusPublished - Jul 2019

Cite this

Filippi, M., Preziosa, P., Banwell, B. L., Barkhof, F., Ciccarelli, O., De Stefano, N., ... Rocca, M. A. (2019). Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines. Brain : a journal of neurology, 142(7), 1858-1875. https://doi.org/10.1093/brain/awz144
Filippi, Massimo ; Preziosa, Paolo ; Banwell, Brenda L ; Barkhof, Frederik ; Ciccarelli, Olga ; De Stefano, Nicola ; Geurts, Jeroen J G ; Paul, Friedemann ; Reich, Daniel S ; Toosy, Ahmed T ; Traboulsee, Anthony ; Wattjes, Mike P ; Yousry, Tarek A ; Gass, Achim ; Lubetzki, Catherine ; Weinshenker, Brian G ; Rocca, Maria A. / Assessment of lesions on magnetic resonance imaging in multiple sclerosis : practical guidelines. In: Brain : a journal of neurology. 2019 ; Vol. 142, No. 7. pp. 1858-1875.
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abstract = "MRI has improved the diagnostic work-up of multiple sclerosis, but inappropriate image interpretation and application of MRI diagnostic criteria contribute to misdiagnosis. Some diseases, now recognized as conditions distinct from multiple sclerosis, may satisfy the MRI criteria for multiple sclerosis (e.g. neuromyelitis optica spectrum disorders, Susac syndrome), thus making the diagnosis of multiple sclerosis more challenging, especially if biomarker testing (such as serum anti-AQP4 antibodies) is not informative. Improvements in MRI technology contribute and promise to better define the typical features of multiple sclerosis lesions (e.g. juxtacortical and periventricular location, cortical involvement). Greater understanding of some key aspects of multiple sclerosis pathobiology has allowed the identification of characteristics more specific to multiple sclerosis (e.g. central vein sign, subpial demyelination and lesional rims), which are not included in the current multiple sclerosis diagnostic criteria. In this review, we provide the clinicians and researchers with a practical guide to enhance the proper recognition of multiple sclerosis lesions, including a thorough definition and illustration of typical MRI features, as well as a discussion of red flags suggestive of alternative diagnoses. We also discuss the possible place of emerging qualitative features of lesions which may become important in the near future.",
author = "Massimo Filippi and Paolo Preziosa and Banwell, {Brenda L} and Frederik Barkhof and Olga Ciccarelli and {De Stefano}, Nicola and Geurts, {Jeroen J G} and Friedemann Paul and Reich, {Daniel S} and Toosy, {Ahmed T} and Anthony Traboulsee and Wattjes, {Mike P} and Yousry, {Tarek A} and Achim Gass and Catherine Lubetzki and Weinshenker, {Brian G} and Rocca, {Maria A}",
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Filippi, M, Preziosa, P, Banwell, BL, Barkhof, F, Ciccarelli, O, De Stefano, N, Geurts, JJG, Paul, F, Reich, DS, Toosy, AT, Traboulsee, A, Wattjes, MP, Yousry, TA, Gass, A, Lubetzki, C, Weinshenker, BG & Rocca, MA 2019, 'Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines' Brain : a journal of neurology, vol. 142, no. 7, pp. 1858-1875. https://doi.org/10.1093/brain/awz144

Assessment of lesions on magnetic resonance imaging in multiple sclerosis : practical guidelines. / Filippi, Massimo; Preziosa, Paolo; Banwell, Brenda L; Barkhof, Frederik; Ciccarelli, Olga; De Stefano, Nicola; Geurts, Jeroen J G; Paul, Friedemann; Reich, Daniel S; Toosy, Ahmed T; Traboulsee, Anthony; Wattjes, Mike P; Yousry, Tarek A; Gass, Achim; Lubetzki, Catherine; Weinshenker, Brian G; Rocca, Maria A.

In: Brain : a journal of neurology, Vol. 142, No. 7, 07.2019, p. 1858-1875.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Assessment of lesions on magnetic resonance imaging in multiple sclerosis

T2 - practical guidelines

AU - Filippi, Massimo

AU - Preziosa, Paolo

AU - Banwell, Brenda L

AU - Barkhof, Frederik

AU - Ciccarelli, Olga

AU - De Stefano, Nicola

AU - Geurts, Jeroen J G

AU - Paul, Friedemann

AU - Reich, Daniel S

AU - Toosy, Ahmed T

AU - Traboulsee, Anthony

AU - Wattjes, Mike P

AU - Yousry, Tarek A

AU - Gass, Achim

AU - Lubetzki, Catherine

AU - Weinshenker, Brian G

AU - Rocca, Maria A

N1 - © The Author(s) (2019). Published by Oxford University Press on behalf of the Guarantors of Brain.

PY - 2019/7

Y1 - 2019/7

N2 - MRI has improved the diagnostic work-up of multiple sclerosis, but inappropriate image interpretation and application of MRI diagnostic criteria contribute to misdiagnosis. Some diseases, now recognized as conditions distinct from multiple sclerosis, may satisfy the MRI criteria for multiple sclerosis (e.g. neuromyelitis optica spectrum disorders, Susac syndrome), thus making the diagnosis of multiple sclerosis more challenging, especially if biomarker testing (such as serum anti-AQP4 antibodies) is not informative. Improvements in MRI technology contribute and promise to better define the typical features of multiple sclerosis lesions (e.g. juxtacortical and periventricular location, cortical involvement). Greater understanding of some key aspects of multiple sclerosis pathobiology has allowed the identification of characteristics more specific to multiple sclerosis (e.g. central vein sign, subpial demyelination and lesional rims), which are not included in the current multiple sclerosis diagnostic criteria. In this review, we provide the clinicians and researchers with a practical guide to enhance the proper recognition of multiple sclerosis lesions, including a thorough definition and illustration of typical MRI features, as well as a discussion of red flags suggestive of alternative diagnoses. We also discuss the possible place of emerging qualitative features of lesions which may become important in the near future.

AB - MRI has improved the diagnostic work-up of multiple sclerosis, but inappropriate image interpretation and application of MRI diagnostic criteria contribute to misdiagnosis. Some diseases, now recognized as conditions distinct from multiple sclerosis, may satisfy the MRI criteria for multiple sclerosis (e.g. neuromyelitis optica spectrum disorders, Susac syndrome), thus making the diagnosis of multiple sclerosis more challenging, especially if biomarker testing (such as serum anti-AQP4 antibodies) is not informative. Improvements in MRI technology contribute and promise to better define the typical features of multiple sclerosis lesions (e.g. juxtacortical and periventricular location, cortical involvement). Greater understanding of some key aspects of multiple sclerosis pathobiology has allowed the identification of characteristics more specific to multiple sclerosis (e.g. central vein sign, subpial demyelination and lesional rims), which are not included in the current multiple sclerosis diagnostic criteria. In this review, we provide the clinicians and researchers with a practical guide to enhance the proper recognition of multiple sclerosis lesions, including a thorough definition and illustration of typical MRI features, as well as a discussion of red flags suggestive of alternative diagnoses. We also discuss the possible place of emerging qualitative features of lesions which may become important in the near future.

U2 - 10.1093/brain/awz144

DO - 10.1093/brain/awz144

M3 - Article

VL - 142

SP - 1858

EP - 1875

JO - Brain : a journal of neurology

JF - Brain : a journal of neurology

SN - 0006-8950

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ER -