Ces radiol. 2011, 65(4):307-316

Multiple sclerosis differential diagnosis by magnetic resonance imagingReview article

Monika Daňová¹, Eleonóra Klímová²

¹ MR Prešov, s.r.o., Fakulta zdravotníctva a sociálnej práce Trnavskej univerzity v Trnave, Slovenská republika

² Klinika neurológie FNsP J. A. Reimana a Fakulty zdravotníckych odborov Prešovskej univerzity v Prešove, Slovenská republika

Diagnosis of Multiple Sclerosis (MS) relies on the evidence of disease dissemination in time and space at the exclusion of other neurological diseases that may clinically or radiologically mimic MS.
While the establishment of criteria to meet the requirements of the diagnosis of MS is given much attention, the criteria for differential diagnosis of MS remain in the background. On the other hand, MRI criteria for dissemination in space is of high specificity (89 %) in those patients who had ruled out other neurological diseases.
Quite often we see in the MRI findings a nonspecific white matter damage, for which we have no clear explanation. There are a diagnostic problems with it, enabling MRI support for a large number of diseases and such findings have not yet been engaged in the criteria used. Simultaneously on MRI scans we meet with the findings of demyelinating lesions suggestive of MS with their measurement and localisation in the white matter, but for example the age of a patient or his clinical course does not fit the pattern of any forms of MS (Fig. 1A,B).
In the context written above, the MRI findings atypical for MS or typical for other neurological diseases may be helpful in the process of differential diagnosis and management of patients with suspected MS. The European group of experts called MAGNIMS (Magnetic Resonance Network in Multiple Sclerosis) defined on the basis of scientific research and evidence exactly this group of diseases, and for practical illustration and highlighting their significance they are marked with red flags.

Keywords: multiple sclerosis, magnetic resonance imaging, differential diagnosis, MAGNIMS

Accepted: August 15, 2011; Published: December 1, 2011  Show citation