TY - JOUR
T1 - Guidelines from the Italian Neurological and Neuroradiological Societies for the use of magnetic resonance imaging in daily life clinical practice of multiple sclerosis patients
AU - Filippi, Massimo
AU - Rocca, Maria A.
AU - Bastianello, Stefano
AU - Comi, Giancarlo
AU - Gallo, Paolo
AU - Gallucci, Massimo
AU - Ghezzi, Angelo
AU - Marrosu, Maria Giovanna
AU - Minonzio, Giorgio
AU - Pantano, Patrizia
AU - Pozzilli, Carlo
AU - Tedeschi, Gioacchino
AU - Trojano, Maria
AU - Falini, Andrea
AU - De Stefano, Nicola
PY - 2013/12
Y1 - 2013/12
N2 - MRI is highly sensitive in detecting focal white matter lesions in multiple sclerosis (MS). For this reason, it has been formally included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, through the definition of ad hoc sets of criteria to show disease dissemination in space and time. MRI is used in virtually all clinical trials of the disease as a surrogate measure of treatment response. Several guidelines have been published to help characterizing the imaging features on conventional MR sequences of "typical" MS lesions and work has also been performed to identify "red flags" which should alert the clinicians to exclude possible alternative conditions. Despite this, the application of the available guidelines and criteria in daily life clinical practice is still limited and varies among and within countries (including Italy) due to regulatory issues and heterogeneity of MRI facilities. It is crucial for neurologists and neuroradiologists to become familiar with these criteria to improve the quality of their diagnostic assessment. In patients with established MS, the main problem is to define standard procedures for monitoring the course of the disease and treatment response. This review aims at providing daily life guidelines to clinicians for a correct application of MRI in the workup of patients suspected of having MS as well as in the monitoring of disease evolution in those with established MS. It also offers clues for the standardization of MRI studies and relative reporting to be applied at a national level.
AB - MRI is highly sensitive in detecting focal white matter lesions in multiple sclerosis (MS). For this reason, it has been formally included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, through the definition of ad hoc sets of criteria to show disease dissemination in space and time. MRI is used in virtually all clinical trials of the disease as a surrogate measure of treatment response. Several guidelines have been published to help characterizing the imaging features on conventional MR sequences of "typical" MS lesions and work has also been performed to identify "red flags" which should alert the clinicians to exclude possible alternative conditions. Despite this, the application of the available guidelines and criteria in daily life clinical practice is still limited and varies among and within countries (including Italy) due to regulatory issues and heterogeneity of MRI facilities. It is crucial for neurologists and neuroradiologists to become familiar with these criteria to improve the quality of their diagnostic assessment. In patients with established MS, the main problem is to define standard procedures for monitoring the course of the disease and treatment response. This review aims at providing daily life guidelines to clinicians for a correct application of MRI in the workup of patients suspected of having MS as well as in the monitoring of disease evolution in those with established MS. It also offers clues for the standardization of MRI studies and relative reporting to be applied at a national level.
KW - Clinically isolated syndromes
KW - Diagnosis
KW - Magnetic resonance imaging
KW - Monitoring
KW - Multiple sclerosis
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U2 - 10.1007/s10072-013-1485-7
DO - 10.1007/s10072-013-1485-7
M3 - Article
C2 - 23828372
AN - SCOPUS:84890561132
VL - 34
SP - 2085
EP - 2093
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 12
ER -