Routine MR Imaging Protocol and Standardization in Central Nervous System Demyelinating Diseases - 26/06/24

Doi : 10.1016/j.nic.2024.03.002

Anthony Traboulsee, MD ^a,^⁎ , David K.B. Li, MD ^b
^a Department of Medicine (Neurology), University of British Columbia, University of British Columbia Hospital, 2211 Wesbrook Mall, Room S113, Vancouver, British Columbia V6T 2B5, Canada
^b Department of Radiology, University of British Columbia, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada

^∗Corresponding author. 2211 Wesbrook Mall, Room S113, Vancouver, British Columbia V6T 2B5, Canada.2211 Wesbrook Mall, Room S113VancouverBritish ColumbiaV6T 2B5Canada

Résumé

Standardized MR imaging protocols are important for the diagnosis and monitoring of patients with multiple sclerosis (MS) and the appropriate use of MR imaging in routine clinical practice. Advances in using MR imaging to establish an earlier diagnosis of MS, safety concerns regarding intravenous gadolinium-based contrast agents, and the value of spinal cord MR imaging for diagnostic, prognostic, and monitoring purposes suggest a changing role of MR imaging for the management and care of MS patients. The MR imaging protocol emphasizes 3 dimensional acquisitions for optimal comparison over time.

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Keywords : Standardized MR imaging protocol, Brain MR imaging protocol, Spinal cord MR imaging protocol, Optic nerve MR imaging protocol, MR imaging guidelines for multiple sclerosis, MR imaging for progressive multifocal leukoencephalopathy, Gadolinium safety, MR imaging monitoring for multiple sclerosis

Plan

Key points

Introduction

MR imaging protocols

MR imaging scanner requirements

Brain protocol CORE and optional sequences

T₂-Weighted Fluid Attenuation Inversion Recovery Sequence (CORE)

Axial T₂-Weighted Sequence (CORE)

Postcontrast Axial T₁-Weighted Sequence (CORE for Diagnosis)

Diffusion-Weighted Imaging Sequences (CORE for Safety Monitoring)

Susceptibility-Weighted Imaging (Optional for Diagnosis and Prognosis)

Three Dimensional T₁ Gradient Echo Sequence (Optional for Brain Volume Quantification)

Double Inversion Recovery and Phase-Sensitive Inversion Recovery Sequences (Optional for Identifying Cortical Lesions)

Spinal Cord Protocol

Optic Nerve Protocol

Research MR Imaging Protocol

Clinical applications

Supporting the Diagnosis of Multiple Sclerosis: Brain and Cord MR Imaging with Gadolinium-based Contrast Agent for Dissemination in Space and Time

Supporting the Diagnosis of Multiple Sclerosis: Follow-up Non-Contrast Brain MR Imaging for Dissemination in Time

Diagnosis of Primary Progressive Multiple Sclerosis

Routine Monitoring for New Inflammatory Lesions

Safety Monitoring for Patients at Risk for Progressive Multifocal Leukoencephalopathy

Routine Monitoring for Disease Progression

Special Populations: Radiologic Isolated Syndrome

Pregnancy and Lactation

Pediatric Multiple Sclerosis Diagnosis and Monitoring

Re-evaluating a Diagnosis of Multiple Sclerosis

Communication: Requisition Recommendations

Communication: Reporting Recommendations

Implementation of a Standardized MR Imaging Protocol

Summary

Clinics care points

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Vol 34 - N° 3

P. 317-334 - août 2024 Retour au numéro

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Diagnostic Criteria for Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorders, and Myelin Oligodendrocyte Glycoprotein–immunoglobulin G-associated Disease
Massimo Filippi, Paolo Preziosa, Monica Margoni, Maria A. Rocca

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Advanced Brain Imaging in Central Nervous System Demyelinating Diseases
Alessandro Cagol, Charidimos Tsagkas, Cristina Granziera

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Routine MR Imaging Protocol and Standardization in Central Nervous System Demyelinating Diseases - 26/06/24

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