Multiple sclerosis MRI: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 16: Line 16:
* We can see <nowiki/>brain atrophy in MS patient especially in the thalamus areas. some studies show that thalamus atrophy can be an indicator of disease progression.<ref name="pmid11844733">{{cite journal |vauthors=Chard DT, Griffin CM, Parker GJ, Kapoor R, Thompson AJ, Miller DH |title=Brain atrophy in clinically early relapsing-remitting multiple sclerosis |journal=Brain |volume=125 |issue=Pt 2 |pages=327–37 |date=February 2002 |pmid=11844733 |doi= |url=}}</ref><ref name="pmid23613615">{{cite journal |vauthors=Zivadinov R, Havrdová E, Bergsland N, Tyblova M, Hagemeier J, Seidl Z, Dwyer MG, Vaneckova M, Krasensky J, Carl E, Kalincik T, Horáková D |title=Thalamic atrophy is associated with development of clinically definite multiple sclerosis |journal=Radiology |volume=268 |issue=3 |pages=831–41 |date=September 2013 |pmid=23613615 |doi=10.1148/radiol.13122424 |url=}}</ref>
* We can see <nowiki/>brain atrophy in MS patient especially in the thalamus areas. some studies show that thalamus atrophy can be an indicator of disease progression.<ref name="pmid11844733">{{cite journal |vauthors=Chard DT, Griffin CM, Parker GJ, Kapoor R, Thompson AJ, Miller DH |title=Brain atrophy in clinically early relapsing-remitting multiple sclerosis |journal=Brain |volume=125 |issue=Pt 2 |pages=327–37 |date=February 2002 |pmid=11844733 |doi= |url=}}</ref><ref name="pmid23613615">{{cite journal |vauthors=Zivadinov R, Havrdová E, Bergsland N, Tyblova M, Hagemeier J, Seidl Z, Dwyer MG, Vaneckova M, Krasensky J, Carl E, Kalincik T, Horáková D |title=Thalamic atrophy is associated with development of clinically definite multiple sclerosis |journal=Radiology |volume=268 |issue=3 |pages=831–41 |date=September 2013 |pmid=23613615 |doi=10.1148/radiol.13122424 |url=}}</ref>
NOTE: To differentiate acute and chronic lesion from each other, we most know that acute lesions tends to be larger in size with poor defined border, but chronic lesion are smaller due to reduction of inflammation and edema and have sharp borders in imaging.<ref name="pmid12051469">{{cite journal |vauthors=Ingle GT, Thompson AJ, Miller DH |title=Magnetic resonance imaging in primary progressive multiple sclerosis |journal=J Rehabil Res Dev |volume=39 |issue=2 |pages=261–71 |date=2002 |pmid=12051469 |doi= |url=}}</ref>   
NOTE: To differentiate acute and chronic lesion from each other, we most know that acute lesions tends to be larger in size with poor defined border, but chronic lesion are smaller due to reduction of inflammation and edema and have sharp borders in imaging.<ref name="pmid12051469">{{cite journal |vauthors=Ingle GT, Thompson AJ, Miller DH |title=Magnetic resonance imaging in primary progressive multiple sclerosis |journal=J Rehabil Res Dev |volume=39 |issue=2 |pages=261–71 |date=2002 |pmid=12051469 |doi= |url=}}</ref>   
[[File:Multiple-sclerosis-6.jpg|500px|none|thumb|
Case courtesy of <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/11646">rID: 11646</a>]]





Revision as of 16:32, 15 February 2019

Multiple sclerosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Multiple sclerosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography or Ultrasound

CT Scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Alternative Therapies

Primary Prevention

Secondary Prevention

Tertiary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Multiple sclerosis MRI On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Multiple sclerosis MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Multiple sclerosis MRI

CDC on Multiple sclerosis MRI

Multiple sclerosis MRI in the news

Blogs on Multiple sclerosis MRI

Directions to Hospitals Treating Multiple sclerosis

Risk calculators and risk factors for Multiple sclerosis MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

On MRI, multiple sclerosis is characterized by cerebral plaques which are demyelinating areas.[1] These lesions are commonly void, and located in periventricular white matter, cerebellum, and the brain stem.[2] These lesions are hyperintense on T2 sections of a MRI.

MRI

MRI may be helpful in the diagnosis of multiple sclerosis. Findings on MRI diagnostic of multiple sclerosis include:

  • Disseminating lesions in space and time.
  • Spinal cords lesions are common in MS disease and are often symptomatic. These lesions are focal or diffuse, small land located mostly in the cervical spinal cord. spinal cord findings can be very helpful for diagnosing MS rather than brain MRI only.[5][6][7]
  • On T1-weighted MRI, MS lesions are isointens to white matter, but sometimes we see these lesions as a hypointens lesions called “black holes” mostly seen in supratentorial region . These black holes can disappear after several months due to remyelination but persistent black hole lesion can be a marker of active disease and demyelination injury.[8][9][10]
  • We can see brain atrophy in MS patient especially in the thalamus areas. some studies show that thalamus atrophy can be an indicator of disease progression.[11][12]

NOTE: To differentiate acute and chronic lesion from each other, we most know that acute lesions tends to be larger in size with poor defined border, but chronic lesion are smaller due to reduction of inflammation and edema and have sharp borders in imaging.[13]

Case courtesy of <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/11646">rID: 11646</a>


References

  1. 1.0 1.1 Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mörk S, Bö L (January 1998). "Axonal transection in the lesions of multiple sclerosis". N. Engl. J. Med. 338 (5): 278–85. doi:10.1056/NEJM199801293380502. PMID 9445407.
  2. 2.0 2.1 Fazekas F, Barkhof F, Filippi M, Grossman RI, Li DK, McDonald WI, McFarland HF, Paty DW, Simon JH, Wolinsky JS, Miller DH (August 1999). "The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis". Neurology. 53 (3): 448–56. PMID 10449103.
  3. Bakshi R, Shaikh ZA, Janardhan V (January 2000). "MRI T2 shortening ('black T2') in multiple sclerosis: frequency, location, and clinical correlation". Neuroreport. 11 (1): 15–21. PMID 10683822.
  4. Bakshi R, Dmochowski J, Shaikh ZA, Jacobs L (March 2001). "Gray matter T2 hypointensity is related to plaques and atrophy in the brains of multiple sclerosis patients". J. Neurol. Sci. 185 (1): 19–26. PMID 11266686.
  5. Lukas C, Sombekke MH, Bellenberg B, Hahn HK, Popescu V, Bendfeldt K, Radue EW, Gass A, Borgwardt SJ, Kappos L, Naegelin Y, Knol DL, Polman CH, Geurts JJ, Barkhof F, Vrenken H (November 2013). "Relevance of spinal cord abnormalities to clinical disability in multiple sclerosis: MR imaging findings in a large cohort of patients". Radiology. 269 (2): 542–52. doi:10.1148/radiol.13122566. PMID 23737540.
  6. Nijeholt GJ, van Walderveen MA, Castelijns JA, van Waesberghe JH, Polman C, Scheltens P, Rosier PF, Jongen PJ, Barkhof F (April 1998). "Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms". Brain. 121 ( Pt 4): 687–97. PMID 9577394.
  7. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (July 2001). "Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis". Ann. Neurol. 50 (1): 121–7. PMID 11456302.
  8. van Walderveen MA, Kamphorst W, Scheltens P, van Waesberghe JH, Ravid R, Valk J, Polman CH, Barkhof F (May 1998). "Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis". Neurology. 50 (5): 1282–8. PMID 9595975.
  9. Simon JH, Lull J, Jacobs LD, Rudick RA, Cookfair DL, Herndon RM, Richert JR, Salazar AM, Sheeder J, Miller D, McCabe K, Serra A, Campion MK, Fischer JS, Goodkin DE, Simonian N, Lajaunie M, Wende K, Martens-Davidson A, Kinkel RP, Munschauer FE (July 2000). "A longitudinal study of T1 hypointense lesions in relapsing MS: MSCRG trial of interferon beta-1a. Multiple Sclerosis Collaborative Research Group". Neurology. 55 (2): 185–92. PMID 10908888.
  10. Bitsch A, Kuhlmann T, Stadelmann C, Lassmann H, Lucchinetti C, Brück W (June 2001). "A longitudinal MRI study of histopathologically defined hypointense multiple sclerosis lesions". Ann. Neurol. 49 (6): 793–6. PMID 11409432.
  11. Chard DT, Griffin CM, Parker GJ, Kapoor R, Thompson AJ, Miller DH (February 2002). "Brain atrophy in clinically early relapsing-remitting multiple sclerosis". Brain. 125 (Pt 2): 327–37. PMID 11844733.
  12. Zivadinov R, Havrdová E, Bergsland N, Tyblova M, Hagemeier J, Seidl Z, Dwyer MG, Vaneckova M, Krasensky J, Carl E, Kalincik T, Horáková D (September 2013). "Thalamic atrophy is associated with development of clinically definite multiple sclerosis". Radiology. 268 (3): 831–41. doi:10.1148/radiol.13122424. PMID 23613615.
  13. Ingle GT, Thompson AJ, Miller DH (2002). "Magnetic resonance imaging in primary progressive multiple sclerosis". J Rehabil Res Dev. 39 (2): 261–71. PMID 12051469.

Template:WH Template:WS