title: Central nervous system infectious diseases mimicking multiple sclerosis: recognizing distinguishable features using MRI.
abstract: The current diagnostic criteria for multiple sclerosis (MS) confirm the relevant role of magnetic resonance imaging (MRI), supporting the possibility of characterizing the dissemination in space (DIS) and the dissemination in time (DIT) in a single scan. To maintain the specificity of these criteria, it is necessary to determine whether T2/FLAIR visible lesions and the gadolinium enhancement can be attributed to diseases that mimic MS. Several diseases are included in the MS differential diagnosis list, including diseases with exacerbation, remitting periods and numerous treatable infectious diseases, which can mimic the MRI features of MS. We discuss the most relevant imaging features in several infectious diseases that resemble MS and examine the primary spatial distributions of lesions and the gadolinium enhancement patterns related to MS. Recognizing imaging "red flags" can be useful for the proper diagnostic evaluation of suspected cases of MS, facilitating the correct differential diagnosis by assessing the combined clinical, laboratory and MR imaging information.
authors.affiliation: Santa Casa de São Paulo, Faculdade de Ciências Médicas, Departamento de Clínica Médica, São PauloSP, Brazil.
authors.forename: Antônio José da
authors.initials: AJ
authors.lastname: Rocha
authors.forename: Ingrid Aguiar
authors.initials: IA
authors.lastname: Littig
authors.forename: Renato Hoffmann
authors.initials: RH
authors.lastname: Nunes
authors.forename: Charles Peter
authors.initials: CP
authors.lastname: Tilbery
mesh_terms: D002494:Central Nervous System Infections / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009103:Multiple Sclerosis / Q000175:diagnosis*