A PROSPECTIVE STUDY USING 3T T2 MRI PREDICTS MS IN UNCERTAIN CASES

BackgroundThere is no absolute biomarker for the diagnosis of multiple sclerosis (MS). White matter lesion (WML) central veins detected using T2* weighted imaging is proving promising.ObjectivesTo confirm if the proportion of WMLs with central veins can predict the clinical diagnosis in a cohort of patients with diagnostic uncertainty of MS.MethodsPatients had a 3T T2* weighted MRI scan and then followed up by their neurologists until a diagnosis was confirmed. The T2* scan was reviewed by a rater blinded to all clinical data and a radiological diagnosis of MS or non-MS made, based purely on the proportion of WMLs with central veins (≥40%=MS). A simpler diagnostic rule of identifying 6 WMLs with central veins for a diagnosis of MS was also employed.ResultsOf the 22 patients scanned to date, 10 patients have received a clinical diagnosis. Two of three patients who were diagnosed with MS had more than 40% of WMLs with central veins. The remaining 7 patients who were diagnosed as non-MS had less than 40% of WMLs with central veins. 9/10 MRI diagnoses appear to be correct. Identifying a subset of 6 WMLs with central veins led to 8/10 correct diagnoses.ConclusionsWML central veins appear to be of value in the diagnostic process for MS when other tests fail at initial presentation.