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. 2018 Sep;8(9):e01042.
doi: 10.1002/brb3.1042. Epub 2018 Aug 2.

MRI in predicting conversion to multiple sclerosis within 1 year

Ayelet Eran  1 , Melissa García  2 , Robair Malouf  3 , Noam Bosak  2 , Raz Wagner  2 , Ester Ganelin-Cohen  4   5 , Elinor Artsy  3 , Alla Shifrin  3 , Ayal Rozenberg  3
Affiliations

MRI in predicting conversion to multiple sclerosis within 1 year

Ayelet Eran et al. Brain Behav. 2018 Sep.

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.

Keywords: demyelinating disease; multiple sclerosis; neuroimaging.

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Figures

Figure 1
Figure 1
A total of 50 patients with a clinically isolated syndrome (CIS) were included in this study. Of them, 25 had a second episode, observed either clinically or via a dynamic change in MRI imaging, and 21 did not show disease progression during the first year after the CIS
Figure 2
Figure 2
The ROC curve for the prediction of a second clinical episode or dynamic change observed on MRI imaging during the year following a first MRI, according to the size of the lesion. Higher risk was associated with a larger diameter of lesions (0.75 cm or more)
See this image and copyright information in PMC

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