Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for a protocol concerning routinely used magnetic resonance imaging in patients with multiple sclerosis
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Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
Medical Diagnostic Centre Voxel, Katowice, Poland
Department of Neurology, Medical University of Lodz, Lodz, Poland
Department of Neuroradiology, Poznan University of Medical Sciences, Poznan, Poland
Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Lodz, Poland
Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
Faculty of Medicine, University of Rzeszow, Rzeszow, Poland
Department of Neurology, Medical University of Bialystok, Bialystok, Poland
Department of Neurology, Jagiellonian University Medical College, University Hospital in Krakow, Krakow, Poland
Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
Department of Neurology, St. Adalbert Hospital, “Copernicus” Ltd., Gdańsk, Poland
Department of Neurology, Pomeranian Medical University, Szczecin, Poland
Department of Neurology, Military Institute of Medicine, Warsaw, Poland
Department of Paediatric Neurology, Warsaw Medical University, Warsaw, Poland
Department of Neurology, Medical University of Lublin, Lublin, Poland
Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
Submission date: 2020-05-05
Final revision date: 2020-05-13
Acceptance date: 2020-05-13
Publication date: 2020-05-26
Pol J Radiol, 2020; 85: 272-276
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis (MS) that is essential for the detection and follow-up of the disease.
The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of their recommendations for investigations routinely conducted in MRI departments in patients with multiple sclerosis. This version includes new data and practical comments for electroradiology technologists and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics necessary for establishing a diagnosis, as well as for MS patient monitoring, which directly translates into significant clinical decisions.
MS is a chronic immune mediated inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in a CNS destruction process disseminated in time and space. MRI detects focal lesions in the white and grey matter with high sensitivity (although with significantly lower specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume and white matter volume as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, and hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in MR techniques, as well as advances in postprocessing the obtained data, has driven the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MRI is unquestionably the best diagnostic tool available to follow up the course of the disease and support clinicians in choosing the most appropriate treatment strategy for their MS patient. However, to diagnose and follow up MS patients on the basis of MRI in accordance with the latest standards, the MRI study must adhere to certain quality criteria. Such criteria are the subject of this paper.
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