Does high field MRI allow an earlier diagnosis of multiple sclerosis?
BACKGROUND
High field magnetic resonance imaging (MRI) provides higher lesion load measurements in patients presenting with clinically isolated syndromes (CIS) suggestive of demyelination and has impact upon the classification of these syndromes and potentially, the diagnosis of multiple sclerosis (MS).


OBJECTIVE
To investigate whether high field MRI can provide an earlier diagnosis of definite MS within the International Panel (IP) and Swanton criteria.


METHODS
Forty patients presenting with CIS suggestive of MS were included. All patients received multi-sequence MRI at 1.5 Tesla (T) and 3T as well as a neurological assessment at baseline. Follow-up visits including MRI at both field strengths and neurological examinations were scheduled 3-4 and 6-7 months after the first clinical event. Based on MRI and clinical findings, fulfilled IP criteria as well as Swanton criteria were analysed.


RESULTS
At baseline, the higher detection rate of inflammatory lesions using high field MRI leads to higher classifications according to the Swanton criteria in 15 % of the patients. One additional patient was diagnosed with dissemination in space according to Swanton and IP criteria. During follow-up, an earlier diagnosis of definite MS could not be accomplished, neither according to the IP nor to the Swanton criteria.


CONCLUSIONS
Although high field MRI shows a higher detection rate of inflammatory brain lesion in CIS and MS patients with an influence according to MRI criteria, this influence does not lead to an earlier diagnosis of lesion dissemination in time and therefore definite MS.
Wattjes
Mike P
MP
Dept. of Radiology/Neuroradiology, University of Bonn, Bonn, Germany. m.wattjes@vumc.nl
Harzheim
Michael
M
Lutterbey
Götz G
GG
Hojati
Ferri
F
Simon
Birgit
B
Schmidt
Stephan
S
Schild
Hans H
HH
Barkhof
Frederik
F
D000328:Adult; D001921:Brain / Q000473:pathology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D009460:Neurologic Examination; D011446:Prospective Studies
D005682:Gadolinium