Update on brain MRI for the diagnosis and follow-up of MS patients

Presse Med. 2021 Jun;50(2):104067. doi: 10.1016/j.lpm.2021.104067. Epub 2021 May 11.

Abstract

Over the past decades, MRI has become a major tool in the diagnosis and the follow-up of patients with multiple sclerosis (MS), especially for monitoring the effectiveness of therapy. The recent international recommendations issued for the standardization of neurological and radiological clinical practices converge on many points. In this setting, recommendations made by the "Observatoire français de la sclérose en plaques", the French MS registry, can be distinguished by its interdisciplinary complementarity, its longevity, its size, and its positions in direct connection with the clinic. Hence, after suspicions of gadolinium deposition in the brain, with multiple warning from the American and European health authorities, a national consultation took place and resulted in limitation to useful injections. The precautionary principle prevailing, the patient receives a limited quantity of contrast product even if no clinically harmful manifestation has been detected to date. The result of this round table bringing together neurologists and neuroradiologists from specialized centers was published in the form of a recommendation in early 2020. The interest of this project also lies in the constant improvement of the management of patients with MS and the possibility of developing advanced techniques to assist the clinician. The aim of this review is to explain to the neurologist, the interest of following this imaging protocol both in his/her clinical practice and in the possibilities that this opens up.

Keywords: Cohort studies; Gadolinium; Magnetic resonance imaging; Multiple sclerosis; OFSEP.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / metabolism
  • Contrast Media / administration & dosage
  • Contrast Media / adverse effects
  • Contrast Media / pharmacokinetics
  • Follow-Up Studies
  • Gadolinium / administration & dosage
  • Gadolinium / adverse effects
  • Gadolinium / pharmacokinetics
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / standards*
  • Multiple Sclerosis / diagnostic imaging*
  • Multiple Sclerosis / therapy
  • Multiple Sclerosis, Relapsing-Remitting / diagnostic imaging
  • Multiple Sclerosis, Relapsing-Remitting / therapy
  • Practice Guidelines as Topic / standards*
  • Registries
  • Treatment Outcome

Substances

  • Contrast Media
  • Gadolinium