The value of magnetic resonance imaging of the optic nerve for the diagnosis of multiple sclerosis in patients with optic neuritis.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2025-01-15 DOI:10.1007/s00415-024-12801-7

Gorm Pihl-Jensen, Jette Lautrup Frederiksen

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Abstract

Background: Although optic neuritis (ON) is common in multiple sclerosis (MS), lesions of the optic nerve are not included as an anatomical substrate for dissemination in space and time (DIS and DIT).

Objective: To assess the increase in sensitivity of including MRI lesions of the optic nerve for the diagnosis of MS in patients with ON.

Methods: We included patients consecutively referred with first time, monosymptomatic ON, with no known cause of the ON, who underwent orbital MRI including fat suppressed T2 and T1-sequences with and without gadolinium contrast.

Results: One hundred and twenty patients were included. Optic nerve T2 lesions and/or T1-contrast enhancement was shown in 104 patients. Sixty-three patients were diagnosed with MS at baseline. Nine patients developed MS during follow-up. The inclusion of optic nerve MRI lesions led to the diagnosis of 8 additional patients and increased sensitivity to 0.99 (95% CI 0.96-1.00) compared to 0.88 (95% CI 0.79-0.95) for 2017 criteria, while decreasing the specificity to 0.81 (95% CI 0.70-0.92) compared to 1.00.

Conclusion: Amending the diagnostic criteria for MS to include MRI lesions of the optic nerve as a substrate for DIS and DIT may increase sensitivity and lead to more rapid diagnosis of MS.

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视神经磁共振成像对视神经炎多发性硬化症的诊断价值。

背景：虽然视神经炎（ON）在多发性硬化症（MS）中很常见，但视神经病变不包括在空间和时间上传播的解剖学基础（DIS和DIT）。目的：探讨视神经MRI病变对多发性硬化症诊断的敏感性。方法：我们纳入了首次就诊的单症状性ON，不明原因的ON患者，他们接受了眼眶MRI，包括脂肪抑制T2和t1序列，有或没有钆造影剂。结果：纳入120例患者。104例患者出现视神经T2病变和/或t1对比增强。63例患者在基线时被诊断为多发性硬化症。9例患者在随访期间发生多发性硬化症。视神经MRI病变的纳入导致了8例额外的患者诊断，敏感性从2017年的0.88 （95% CI 0.79-0.95）增加到0.99 (95% CI 0.96-1.00)，而特异性从1.00降低到0.81 （95% CI 0.70-0.92）。结论：修改MS的诊断标准，将视神经MRI病变作为DIS和DIT的底物，可提高MS的敏感性，使MS的诊断更加快速。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.