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MRI of acute optic neuritis (ON) at the first episode: Can we predict the visual outcome and the development of multiple sclerosis (MS)?

  • EMERGENCY RADIOLOGY
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Abstract

Aim

Our aim was to assess MRI findings in the acute phase of ON and their correlation with visual acuity at presentation, visual outcome (VO) and MS development, to analyze a possible correlation between lesions number and diagnosis, and to assess correlation between orbits MRI and OCT.

Materials and methods

We retrospectively studied 37 patients, who presented to our Emergency Department with an ON first episode from January 2015 to January 2017. Patients underwent immediately a complete neuro-ophthalmological evaluation, blood test, CSF analysis. MRI of brain, orbits, cervical spine was executed within 7 days from ON onset. Brain MRI was classified as: normal, non-specific, suspected demyelination, lesions with dissemination in space and time. Optic nerves findings were localized in three sites (intra-orbital, canalicular and chiasmal) and classified as: normal, STIR- alteration, altered contrast enhancement. Patients underwent neuro-ophthalmological follow-up and MRI at 6 months to assess VO (complete recovery, partial recovery, deficit persistence). Another follow-up at 1 year was performed to identify MS or clinically isolated syndrome (CIS).

Results

64.8% patients received a diagnosis of MS; 35% of CIS. Lesions of the optic nerve were found in 65.8%. We observed statistically significant correlation between brain MRI pattern and diagnosis and between lesions number and diagnosis. We observed a statistically significant correlation between orbital MRI pattern and optical coherence tomography (OCT) results. MRI brain findings correlate with development of MS. MRI brain features and lesions number can predict the risk of MS conversion.

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Author information

Authors and Affiliations

  1. Radiology Department, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20123, Milan, Italy

    Michaela Cellina, Marcello Orsi & Giancarlo Oliva

  2. Radiology Department, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy

    Chiara Floridi

  3. Department of Radiology, Civil Hospital, Corso Milano 19, 27029, Vigevano, Italy

    Cristina Rosti

  4. Radiology Department, IRCCS Ospedale San Raffaele, Via Olgettina 23, 20121, Milan, Italy

    Marta Panzeri

  5. Neurology Department, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20123, Milan, Italy

    Marta Pirovano & Matteo Ciocca

  6. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20121, Milan, Italy

    Daniele Gibelli

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  1. Michaela Cellina
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Corresponding author

Correspondence to Michaela Cellina.

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The authors declare that they have no conflict of interest.

Ethical standards

As stated in Materials and Methods, this retrospective study has been approved by our Institutional Review Board (Institutional Review Board Area 1 Milan; reference number: 2018/ST/116). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Cellina, M., Floridi, C., Rosti, C. et al. MRI of acute optic neuritis (ON) at the first episode: Can we predict the visual outcome and the development of multiple sclerosis (MS)?. Radiol med 124, 1296–1303 (2019). https://doi.org/10.1007/s11547-019-01073-1

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  • DOI: https://doi.org/10.1007/s11547-019-01073-1

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