title: Is size an essential criterion to define tumefactive plaque? MR features and clinical correlation in multiple sclerosis.
abstract: Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. It has recently been described as a rare subtype of multiple sclerosis (MS) characterised by the appearance of solitary or multiple space-occupying lesions associated with imaging characteristics mimicking neoplasm. Atypical features include plaque size >2 cm with mass effect, oedema, and/or ring enhancement on magnetic resonance (MR) images.This study is a retrospective review designed to evaluate the prevalence of tumefactive plaques in a selected population of 440 MS patients referred to our MS centre in Southern Italy between 2005 and 2014. We analysed the radiographic features of lesions ranging in size from 0.5 to 2 cm to establish whether smaller plaques with MR characteristics similar to tumefactive plaques present different symptoms, disease evolution and prognosis. We also aimed to ascertain if MR features suggestive of biological aggressiveness could be useful prognostic criteria for a correct diagnosis of the disease and subsequent treatment. Our data suggest that lesions 0.5-2 cm and >2 cm have similar MR features and clinical evolution.
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Patriarca
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Torlone
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Ferrari
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, San Salvatore Hospital, L'Aquila, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Di Carmine
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, San Salvatore Hospital, L'Aquila, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Totaro
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: di Cesare
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy alessandra.splendiani@cc.univaq.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Splendiani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Multiple sclerosis; magnetic resonance imaging; tumefactive demyelinating lesions