Department of Neurology, Oregon Health & Science University, Portland, USA.
Curr Neurol Neurosci Rep. 2011 Oct;11(5):498-506. doi: 10.1007/s11910-011-0213-z.
The advent and wide use of magnetic resonance brain imaging has led to in the unexpected detection of lesions that appear typical of multiple sclerosis (MS) in otherwise asymptomatic patients. Several cohorts of patients with the "radiologically isolated syndrome (RIS)" have been studied mainly retrospectively, and a proportion of them do go on to have clinical symptoms of MS. This has led to the not infrequent clinical conundrum of whether or not to treat patients with MRI lesions suggestive of MS, given the knowledge that MS disease-modifying therapies work best when given early in the disease course. However, the decision to proactively treat patients with RIS is countered by the increasing risks associated with MS disease-modifying therapies as well as the uncertain prognostic outcome of RIS. This review will highlight what is and is not known about the long-term outcomes of RIS and present recommendations for clinicians when faced with this challenging situation.
磁共振脑成像的出现和广泛应用导致了在 otherwise asymptomatic 患者中意外检测到表现为多发性硬化症 (MS) 的典型病变。已经对几批具有“放射孤立综合征 (RIS)”的患者进行了研究，主要是回顾性的，其中一部分确实会出现 MS 的临床症状。这导致了一个并不少见的临床难题，即是否应该治疗 MRI 显示有 MS 病变的患者，因为人们知道，在疾病早期使用 MS 疾病修饰疗法效果最佳。然而，鉴于 MS 疾病修饰疗法的风险增加以及 RIS 的预后结果不确定，积极治疗 RIS 患者的决定受到了阻碍。本综述将重点介绍关于 RIS 的长期结果的已知和未知内容，并为临床医生在面对这种具有挑战性的情况时提供建议。
