Open AccessMRI in predicting conversion to multiple sclerosis within 1 year
Author(s) -
Eran Ayelet,
García Melissa,
Malouf Robair,
Bosak Noam,
Wagner Raz,
GanelinCohen Ester,
Artsy Elinor,
Shifrin Alla,
Rozenberg Ayal
Publication year - 2018
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.1042
Subject(s) - lesion , medicine , multiple sclerosis , corpus callosum , clinically isolated syndrome , magnetic resonance imaging , radiology , neuroradiologist , mcdonald criteria , medical record , pathology , psychiatry
Abstract Objectives Most patients diagnosed with multiple sclerosis ( MS ) present with a clinically isolated syndrome ( CIS ). We aimed to verify previously reported imaging and clinical findings, and to identify new MRI findings that might serve as prognostic factors for a second clinical episode or a change in the MRI scan during the first year following a CIS . Materials and Methods We identified from our medical records, 46 individuals who presented with an episode of CIS , which was followed clinically and with imaging studies. A neuroradiologist blinded to the clinical data reviewed the images and recorded the number of lesions, lesion location, and the largest longitudinal diameter of the lesion. Results One year after the first MRI , 25 (54%) patients had progressed to MS . The clinical presentation of those who were and were not diagnosed with MS was predominantly motor or sensory deficit. Patients with lesions that were temporal, occipital, or perpendicular to the corpus callosum at the first episode were more likely to have recurrence. Individuals with a combination of more than 13 lesions, with maximal lesion length greater than 0.75 cm, and a lesion perpendicular to the corpus callosum, had a 19 times higher chance of conversion MS during the following year. Conclusions Assessment of the number of lesions, lesion location, and maximal lesion size can predict the risk to develop another clinical episode or a new lesion/new enhancement in MRI during the year after CIS . For patients with a higher risk of recurrence, we recommend closer follow‐up.