학술논문
Magnetic Resonance Imaging in Primary Progressive Multiple Sclerosis Patients
Review Article
Review Article
Document Type
Academic Journal
Author
Source
Clinical Neuroradiology. September 2022, Vol. 32 Issue 3, p625, 17 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Author(s): Malgorzata Siger [sup.1] Author Affiliations: (1) grid.8267.b, 0000 0001 2165 3025, Department of Neurology, Medical University of Lódz, , 22 Kopcinskiego Str., 90-153, Lódz, Poland Introduction In recent years, [...]
The recently developed effective treatment of primary progressive multiple sclerosis (PPMS) requires the accurate diagnosis of patients with this type of disease. Currently, the diagnosis of PPMS is based on the 2017 McDonald criteria, although the contribution of magnetic resonance imaging (MRI) to this process is fundamental. PPMS, one of the clinical types of MS, represents 10%-15% of all MS patients. Compared to relapsing-remitting MS (RRMS), PPMS differs in terms of pathology, clinical presentation and MRI features. Regarding conventional MRI, focal lesions on T2-weighted images and acute inflammatory lesions with contrast enhancement are less common in PPMS than in RRMS. On the other hand, MRI features of chronic inflammation, such as slowly evolving/expanding lesions (SELs) and leptomeningeal enhancement (LME), and brain and spinal cord atrophy are more common MRI characteristics in PPMS than RRMS. Nonconventional MRI also shows differences in subtle white and grey matter damage between PPMS and other clinical types of disease. In this review, we present separate diagnostic criteria, conventional and nonconventional MRI specificity for PPMS, which may support and simplify the diagnosis of this type of MS in daily clinical practice.
The recently developed effective treatment of primary progressive multiple sclerosis (PPMS) requires the accurate diagnosis of patients with this type of disease. Currently, the diagnosis of PPMS is based on the 2017 McDonald criteria, although the contribution of magnetic resonance imaging (MRI) to this process is fundamental. PPMS, one of the clinical types of MS, represents 10%-15% of all MS patients. Compared to relapsing-remitting MS (RRMS), PPMS differs in terms of pathology, clinical presentation and MRI features. Regarding conventional MRI, focal lesions on T2-weighted images and acute inflammatory lesions with contrast enhancement are less common in PPMS than in RRMS. On the other hand, MRI features of chronic inflammation, such as slowly evolving/expanding lesions (SELs) and leptomeningeal enhancement (LME), and brain and spinal cord atrophy are more common MRI characteristics in PPMS than RRMS. Nonconventional MRI also shows differences in subtle white and grey matter damage between PPMS and other clinical types of disease. In this review, we present separate diagnostic criteria, conventional and nonconventional MRI specificity for PPMS, which may support and simplify the diagnosis of this type of MS in daily clinical practice.