Fazekas F, Barkhof F, Filippi M, Grossman R I, Li D K, McDonald W I, McFarland H F, Paty D W, Simon J H, Wolinsky J S, Miller D H
Department of Neurology and MRI Center, Karl-Franzens University, Graz, Austria.
Neurology. 1999 Aug 11;53(3):448-56. doi: 10.1212/wnl.53.3.448.
MRI is very sensitive in showing MS lesions throughout the CNS. Using MRI for diagnostic purposes, however useful, is a complex issue because of limited specificity of findings and a variety of options as to when, how, and which patients to examine. Comparability of data and a common view regarding the impact of MRI are needed. Following a review of the typical appearance and pattern of MS lesions including differential diagnostic considerations, we suggest economic MRI examination protocols for the brain and spine. Recommendations for referral to MRI consider the need to avoid misdiagnosis and the probability of detecting findings of diagnostic relevance. We also suggest MRI classes of evidence for MS to determine the diagnostic weight of findings and their incorporation into the clinical evaluation. These proposals should help to optimize and standardize the use of MRI in the diagnosis of MS.
MRI在显示整个中枢神经系统的多发性硬化（MS）病变方面非常敏感。然而，将MRI用于诊断目的，无论多么有用，都是一个复杂的问题，因为检查结果的特异性有限，而且在何时、如何以及对哪些患者进行检查方面有多种选择。需要数据的可比性以及关于MRI影响的共识。在回顾了MS病变的典型表现和模式，包括鉴别诊断考虑因素之后，我们提出了针对脑和脊柱的经济MRI检查方案。关于转诊进行MRI检查的建议考虑到避免误诊的必要性以及检测到具有诊断相关性结果的可能性。我们还建议对MS的MRI证据进行分类，以确定检查结果的诊断权重及其纳入临床评估的情况。这些提议应有助于优化和规范MRI在MS诊断中的应用。
