Magnetic resonance imaging and other techniques in the diagnosis of multiple sclerosis
H. S. Kirshner, S. I. Tsai, V. M. Runge and A. C. Price
We evaluated 35 patients with multiple sclerosis (MS) by magnetic resonance
imaging (MRI), cerebrospinal fluid (CSF) analysis, evoked potential
testing, and computed tomographic (CT) scanning. As classified by the
McAlpine et al and McDonald and Halliday criteria, 27 patients had definite
MS, three had probable MS, and five had possible MS. All of the patients
had multiple white matter lesions detectable by MRI that were evident
predominantly in the periventricular areas but also in the cerebral or
cerebellar white matter. The severity of the MRI abnormality, as judged by
the number and size of the lesions, correlated with the likelihood of a
positive CT scan but not with the duration of disease, the degree of
disability, or positive CSF oligoclonal banding. Magnetic resonance imaging
successfully demonstrated brain-stem lesions in 15 patients (none were seen
on CT scans). Magnetic resonance imaging seems to be a sensitive indicator
of MS lesions, but clinical assessment will continue to be crucial to the
diagnosis of MS.
