Using a particular type of MRI scan may speed up diagnosis

Using magnetic resonance imaging (MRI) in a different way to look for evidence of multiple sclerosis (MS) in the brain could be a step towards earlier diagnosis of the disease, according to new research published in the journal Multiple Sclerosis.

MRI is a valuable tool for detecting and diagnosing brain abnormalities, and it is particularly useful in the evaluation of damage to the white matter of the brain. However, white matter lesions in the brains of people with MS are not always an indicator of the disease. New research has highlighted a way in which the clinical MRI scanners available in specialist neuroscience centres could be used to distinguish between MS-related white matter lesions and other ‘white spots’ in the brain.

Researchers at the University of Nottingham and the Nottingham University Hospitals NHS Trust used a special type of MRI, called T2-weighted MRI, to reveal a distinctive feature of MS, white matter lesions with a central vein. In the first part of their study, a test cohort of 10 individuals with MS and 10 individuals with non-MS white matter lesions underwent T2-weighted MRI. After evaluating the scans, the researchers formulated diagnostic rules based on the number and morphology of lesions with a central vein. A second cohort of 20 people (13 with MS) was then assessed by the same process.

In the first cohort, people with MS were found to have a higher proportion of lesions with a central vein than those in the non-MS group: all people with MS had central veins visible in more than 45% of lesions, while individuals with non-MS-related white spots had central veins visible in fewer than 45% of lesions (p < 0.0001). By applying the newly formulated diagnostic rules to the second cohort, all participants were correctly categorized by a blinded observer into those with MS and those without MS.

Dr Nikos Evangelo, who led the study, said: “Our results show that clinical application of this technique could supplement existing diagnostic methods for MS.”

The recommendations outlined in Brain health: time matters in multiple sclerosis emphasize the importance of maximizing brain health in people with MS. This research represents a step towards increasing the speed of diagnosis which will directly contribute to improving brain health for people with MS.

Reference

  1. Mistry N, Abdel-Fahim R, Samaraweera A et al. Imaging central veins in brain lesions with 3-T T2*-weighted magnetic resonance imaging differentiates multiple sclerosis from microangiopathic brain lesions. Mult Scler 2015;Epub ahead of print.

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