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Spinal-cord MRI in multiple sclerosis.
Lancet Neurol 2003; 2(9):555-62LN

Abstract

The potential of MRI of the spinal cord as a diagnostic tool in MS has recently gained much interest. Dual echo spin echo MRI is most sensitive for the detection of spinal-cord abnormalities, which range from multiple focal lesions to confluent areas of high signal intensity. In some patients, commonly those with primary progressive disease, diffuse areas of slightly increased signal intensity are found. Disappointingly, the relation between MRI findings and clinical disability is weak. Studies relating MRI findings with histopathology have revealed substantial axonal loss in the spinal cords of patients with MS, whether focal lesions are present of not. Further, diffuse cord atrophy is found in advanced MS, which may reflect axonal loss. In the diagnostic setting, spinal-cord imaging is valuable. First, asymptomatic spinal-cord lesions are very rare in disorders other than MS. For example, in a patient with equivocal brain findings such as an elderly patient with vascular-ischaemic lesions, a normal spinal-cord examination can help rule out MS. Second, presence of asymptomatic spinal lesions may help confirm a diagnosis of MS when few or no brain lesions are present.

Authors+Show Affiliations

MS-MRI Centre, VU Medical Centre, Department of Radiology, Amsterdam, Netherlands. g.lycklama@vumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12941578

Citation

Lycklama, Geert, et al. "Spinal-cord MRI in Multiple Sclerosis." The Lancet. Neurology, vol. 2, no. 9, 2003, pp. 555-62.
Lycklama G, Thompson A, Filippi M, et al. Spinal-cord MRI in multiple sclerosis. Lancet Neurol. 2003;2(9):555-62.
Lycklama, G., Thompson, A., Filippi, M., Miller, D., Polman, C., Fazekas, F., & Barkhof, F. (2003). Spinal-cord MRI in multiple sclerosis. The Lancet. Neurology, 2(9), pp. 555-62.
Lycklama G, et al. Spinal-cord MRI in Multiple Sclerosis. Lancet Neurol. 2003;2(9):555-62. PubMed PMID: 12941578.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal-cord MRI in multiple sclerosis. AU - Lycklama,Geert, AU - Thompson,Alan, AU - Filippi,Massimo, AU - Miller,David, AU - Polman,Chris, AU - Fazekas,Franz, AU - Barkhof,Frederik, PY - 2003/8/28/pubmed PY - 2003/10/24/medline PY - 2003/8/28/entrez SP - 555 EP - 62 JF - The Lancet. Neurology JO - Lancet Neurol VL - 2 IS - 9 N2 - The potential of MRI of the spinal cord as a diagnostic tool in MS has recently gained much interest. Dual echo spin echo MRI is most sensitive for the detection of spinal-cord abnormalities, which range from multiple focal lesions to confluent areas of high signal intensity. In some patients, commonly those with primary progressive disease, diffuse areas of slightly increased signal intensity are found. Disappointingly, the relation between MRI findings and clinical disability is weak. Studies relating MRI findings with histopathology have revealed substantial axonal loss in the spinal cords of patients with MS, whether focal lesions are present of not. Further, diffuse cord atrophy is found in advanced MS, which may reflect axonal loss. In the diagnostic setting, spinal-cord imaging is valuable. First, asymptomatic spinal-cord lesions are very rare in disorders other than MS. For example, in a patient with equivocal brain findings such as an elderly patient with vascular-ischaemic lesions, a normal spinal-cord examination can help rule out MS. Second, presence of asymptomatic spinal lesions may help confirm a diagnosis of MS when few or no brain lesions are present. SN - 1474-4422 UR - https://www.unboundmedicine.com/medline/citation/12941578/Spinal_cord_MRI_in_multiple_sclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1474442203005040 DB - PRIME DP - Unbound Medicine ER -