open access

Vol 56, No 3 (2022)
Invited Review Article
Submitted: 2021-07-06
Accepted: 2021-09-24
Published online: 2021-10-19
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Increasing role of imaging in differentiating MS from non-MS and defining indeterminate borderline cases

Maciej Juryńczyk1, Paweł Jakuszyk1, Iwona Kurkowska-Jastrzębska2, Jacqueline Palace3
·
Pubmed: 34664709
·
Neurol Neurochir Pol 2022;56(3):210-219.
Affiliations
  1. Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
  2. 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
  3. Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom

open access

Vol 56, No 3 (2022)
INVITED REVIEW ARTICLES — LEADING TOPIC
Submitted: 2021-07-06
Accepted: 2021-09-24
Published online: 2021-10-19

Abstract

Multiple sclerosis (MS) is a heterogenous condition with differences between patients regarding disease presentation, imaging features, disease activity, prognosis and treatment responses. Following the discovery of new biomarkers, the concept of MS has evolved, with syndromes previously considered to be its variants now recognised as separate entities, including aquaporin-4 (AQP4)-antibody (Ab) neuromyelits optica spectrum disorders (NMOSD), and myelin oligodendrocyte glycoprotein (MOG)-Ab disease (MOGAD). In line with their distinct pathology, the newly emerging conditions have imaging characteristics which are dissimilar to typical MS. Progress in reclassifying such demyelinating CNS conditions has highlighted the challenge in meaningful categorisation of atypical presentations at the borders of MS, such as antibody-negative neuromyelitis optica-like syndromes, tumefactive demyelinating lesions, or Balo’s concentric sclerosis.
In this review, we discuss the increasing role of imaging in distinguishing MS from non-MS CNS inflammatory/demyelinating conditions and defining undetermined borderline cases. This progress relies both on better characterisation of imaging features of these conditions on conventional imaging in terms of their appearance and location, as well as on the implementation of novel image acquisition and/or post-processing techniques allowing for more in-depth lesion assessment, including the presence of a central vein sign or paramagnetic rim.

Abstract

Multiple sclerosis (MS) is a heterogenous condition with differences between patients regarding disease presentation, imaging features, disease activity, prognosis and treatment responses. Following the discovery of new biomarkers, the concept of MS has evolved, with syndromes previously considered to be its variants now recognised as separate entities, including aquaporin-4 (AQP4)-antibody (Ab) neuromyelits optica spectrum disorders (NMOSD), and myelin oligodendrocyte glycoprotein (MOG)-Ab disease (MOGAD). In line with their distinct pathology, the newly emerging conditions have imaging characteristics which are dissimilar to typical MS. Progress in reclassifying such demyelinating CNS conditions has highlighted the challenge in meaningful categorisation of atypical presentations at the borders of MS, such as antibody-negative neuromyelitis optica-like syndromes, tumefactive demyelinating lesions, or Balo’s concentric sclerosis.
In this review, we discuss the increasing role of imaging in distinguishing MS from non-MS CNS inflammatory/demyelinating conditions and defining undetermined borderline cases. This progress relies both on better characterisation of imaging features of these conditions on conventional imaging in terms of their appearance and location, as well as on the implementation of novel image acquisition and/or post-processing techniques allowing for more in-depth lesion assessment, including the presence of a central vein sign or paramagnetic rim.

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Keywords

multiple sclerosis, neuromyelits optica

About this article
Title

Increasing role of imaging in differentiating MS from non-MS and defining indeterminate borderline cases

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 56, No 3 (2022)

Article type

Invited Review Article

Pages

210-219

Published online

2021-10-19

Page views

5357

Article views/downloads

1324

DOI

10.5603/PJNNS.a2021.0077

Pubmed

34664709

Bibliographic record

Neurol Neurochir Pol 2022;56(3):210-219.

Keywords

multiple sclerosis
neuromyelits optica

Authors

Maciej Juryńczyk
Paweł Jakuszyk
Iwona Kurkowska-Jastrzębska
Jacqueline Palace

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