Neurological Sciences

, Volume 34, Issue 12, pp 2085–2093

Guidelines from The Italian Neurological and Neuroradiological Societies for the use of magnetic resonance imaging in daily life clinical practice of multiple sclerosis patients

  • Massimo Filippi
  • Maria A. Rocca
  • Stefano Bastianello
  • Giancarlo Comi
  • Paolo Gallo
  • Massimo Gallucci
  • Angelo Ghezzi
  • Maria Giovanna Marrosu
  • Giorgio Minonzio
  • Patrizia Pantano
  • Carlo Pozzilli
  • Gioacchino Tedeschi
  • Maria Trojano
  • Andrea Falini
  • Nicola De Stefano
Review Article

Abstract

MRI is highly sensitive in detecting focal white matter lesions in multiple sclerosis (MS). For this reason, it has been formally included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, through the definition of ad hoc sets of criteria to show disease dissemination in space and time. MRI is used in virtually all clinical trials of the disease as a surrogate measure of treatment response. Several guidelines have been published to help characterizing the imaging features on conventional MR sequences of “typical” MS lesions and work has also been performed to identify “red flags” which should alert the clinicians to exclude possible alternative conditions. Despite this, the application of the available guidelines and criteria in daily life clinical practice is still limited and varies among and within countries (including Italy) due to regulatory issues and heterogeneity of MRI facilities. It is crucial for neurologists and neuroradiologists to become familiar with these criteria to improve the quality of their diagnostic assessment. In patients with established MS, the main problem is to define standard procedures for monitoring the course of the disease and treatment response. This review aims at providing daily life guidelines to clinicians for a correct application of MRI in the workup of patients suspected of having MS as well as in the monitoring of disease evolution in those with established MS. It also offers clues for the standardization of MRI studies and relative reporting to be applied at a national level.

Keywords

Multiple sclerosis  Clinically isolated syndromes  Magnetic resonance imaging  Diagnosis  Monitoring 

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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Massimo Filippi
    • 1
    • 2
  • Maria A. Rocca
    • 1
    • 2
  • Stefano Bastianello
    • 3
  • Giancarlo Comi
    • 2
  • Paolo Gallo
    • 4
  • Massimo Gallucci
    • 5
  • Angelo Ghezzi
    • 6
  • Maria Giovanna Marrosu
    • 7
  • Giorgio Minonzio
    • 8
  • Patrizia Pantano
    • 9
  • Carlo Pozzilli
    • 10
  • Gioacchino Tedeschi
    • 11
  • Maria Trojano
    • 12
  • Andrea Falini
    • 13
  • Nicola De Stefano
    • 14
  1. 1.Neuroimaging Research Unit, Institute of Experimental NeurologySan Raffaele Scientific Institute, Vita-Salute San Raffaele UniversityMilanItaly
  2. 2.Department of NeurologySan Raffaele Scientific Institute, Vita-Salute San Raffaele UniversityMilanItaly
  3. 3.Department of NeuroradiologyIRCCS National Neurological Institute C. Mondino Foundation, University of PaviaPaviaItaly
  4. 4.The Multiple Sclerosis Centre of Veneto Region, First Neurological ClinicDepartment of Neurosciences, University Hospital of PadovaPaduaItaly
  5. 5.Department of Neuroradiology“San Salvatore” HospitalL’AquilaItaly
  6. 6.Multiple Sclerosis CenterHospital of GallarateGallarateItaly
  7. 7.Department of Public Health, Clinical and Molecular Medicine, Multiple Sclerosis CenterUniversity of CagliariCagliariItaly
  8. 8.Department of NeuroradiologyHospital of GallarateGallarateItaly
  9. 9.Neuroradiology SectionSapienza University of RomeRomeItaly
  10. 10.Department of Neurology and PsychiatrySapienza University of RomeRomeItaly
  11. 11.Department of NeurologySecond University of NaplesNaplesItaly
  12. 12.Department of Basic Medical Sciences, Neuroscience and Sense OrgansUniversity of BariBariItaly
  13. 13.Department of Neuroradiology, Division of NeuroscienceSan Raffaele Scientific Institute, Vita-Salute San Raffaele UniversityMilanItaly
  14. 14.Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly

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