Article information
Abstract
Objective
To establish recommendations for using and interpreting magnetic resonance imaging (MRI) results in the diagnosis and follow up of multiple sclerosis (MS).
MethodBased on an extensive review of the literature and on their own experience, an expert group on MS produced a consensus on recommendations for using and interpreting MRI results in MS diagnosis and follow up.
ResultsA brain MRI must be performed whenever possible in the initial diagnosis and assessment of patients suspected with MS. A spinal MRI study should be performed on all patients whose clinical onset shows signs of spinal cord syndrome, when the brain MRI findings are not very specific or when the brain MRI is normal in patients diagnosed clinically with MS. Cranial studies should be performed using appropriate repositioning techniques and different MR sequences, such as proton-density and T2-weighted fast spin-echo, and Fast-FLAIR. The use of contrast is mandatory whenever attempting to determine the temporal and spatial dissemination of demyelinating lesions for the initial diagnosis, or to determine inflammatory activity or lesion progression in follow-up studies.
ConclusionsThe use of recommendations for using and interpreting MRI results in MS diagnosis and follow up should help to rationalise resources and optimise the clinical results arising from its practice.
Keywords:
Multiple sclerosis
Magnetic resonance imaging
Recommendations
Resumen
Objetivo
Establecer unas recomendaciones para utilizar e interpretar la resonancia magnética (RM) en el diagnóstico y el seguimiento de la esclerosis múltiple (EM).
MétodoBasados en una extensa revisión de la literatura y en su propia experiencia personal, un grupo de expertos en EM consensuaron unas recomendaciones con este objetivo.
ResultadosSiempre que sea posible se debe practicar un estudio de RM craneal en el diagnóstico o la evaluación inicial de los pacientes con sospecha de EM. Un estudio de RM espinal debe realizarse en todo paciente cuyo inicio clínico es un síndrome medular, cuando los hallazgos de la RM cerebral sean poco específicos o cuando el estudio de RM cerebral sea normal en pacientes diagnosticados clínicamente de EM. Los estudios cerebrales deben efectuarse con técnicas de reposicionamiento adecuadas y combinando secuencias ponderadas en densidad protónica, T2 y fast-FLAIR. Es obligado utilizar contraste siempre que se pretenda determinar diseminación temporal o espacial de las lesiones desmielinizantes para el diagnóstico inicial, o para determinar actividad inflamatoria o progresión lesional en los estudios de seguimiento.
ConclusionesDisponer de unas recomendaciones para la utilización y la interpretación de los estudios de RM en el diagnóstico y el seguimiento de los pacientes con EM debe servir para racionalizar los recursos y para optimizar los resultados clínicos derivados de su práctica.
Palabras clave:
Esclerosis múltiple
Resonancia magnética
Recomendaciones
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