Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden.
Mult Scler. 2013 Mar;19(3):271-80. doi: 10.1177/1352458512451943. Epub 2012 Jul 3.
With increasing availability of magnetic resonance imaging (MRI), there is also an increase in incidental abnormal findings. MRI findings suggestive of multiple sclerosis in persons without typical multiple sclerosis symptoms and with normal neurological findings are defined as radiologically isolated syndrome (RIS). Half of the persons with RIS have their initial MRI because of headache, and some have a subclinical cognitive impairment similar to that seen in multiple sclerosis. Radiological measurements also show a similarity between RIS and multiple sclerosis. Approximately two-thirds of persons with RIS show radiological progression and one-third develop neurological symptoms during mean follow-up times of up to five years. Cervical cord lesions are important predictors of clinical conversion. Management has to be individualised, but initiation of disease modifying therapy is controversial and not recommended outside of clinical trials since its effects have not been studied in RIS. Future studies should try to establish the prevalence and long-term prognosis of RIS, its impact on quality of life, and define the role of disease modifying therapy in RIS.
随着磁共振成像（MRI）的应用越来越广泛，偶然发现的异常情况也越来越多。在没有典型多发性硬化症状且神经检查正常的人群中，MRI 发现提示多发性硬化的病变被定义为放射孤立综合征（RIS）。有一半的 RIS 患者因头痛而进行首次 MRI 检查，有些患者存在类似于多发性硬化的亚临床认知障碍。影像学测量也显示 RIS 与多发性硬化之间存在相似性。在平均长达五年的随访期间，大约三分之二的 RIS 患者出现影像学进展，三分之一的患者出现神经症状。颈髓病变是临床转化的重要预测因素。管理必须个体化，但在临床试验之外启动疾病修正治疗存在争议，因为尚未在 RIS 中研究其疗效。未来的研究应尝试确定 RIS 的患病率和长期预后、对生活质量的影响，并确定疾病修正治疗在 RIS 中的作用。
