What are the Consortium of MS Centers recommendations for brain and spinal cord imaging for the diagnosis and follow-up of multiple sclerosis (MS)?

Updated: Mar 27, 2019
  • Author: James A Wilson, MD, MSc, FRCPC; Chief Editor: James G Smirniotopoulos, MD  more...
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Answer

Answer

The Consortium of MS Centers Task Force, an international group of neurologists and radiologists, noted the following regarding standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS [8] :

  • A brain MR imaging with gadolinium is recommended for the diagnosis of MS.
  • A spinal cord MR imaging is recommended if the brain MR imaging is nondiagnostic or if the presenting symptoms are at the level of the spinal cord.
  • A follow-up brain MR imaging with gadolinium is recommended to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, to reassess the original diagnosis, and as a new baseline before starting or modifying therapy.
  • A routine brain MR imaging should be considered every 6 months to 2 years for all patients with relapsing MS.
  • The brain MR imaging protocol includes 3D T1-weighted, 3D T2-FLAIR, 3D T2-weighted, post-single-dose gadolinium-enhanced T1-weighted sequences, and a DWI sequence.
  • The progressive multifocal leukoencephalopathy surveillance protocol includes FLAIR and DWI sequences only.
  • The spinal cord MR imaging protocol includes sagittal T1-weighted and proton attenuation, STIR or phase-sensitive inversion recovery, axial T2- or T2*-weighted imaging through suspicious lesions, and, in some cases, postcontrast gadolinium-enhanced T1-weighted imaging.

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