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Abstracts from the Association of British Neurologists Annual Meeting 2011
0930 A single 7T MRI brain scan accurately predicts eventual diagnosis of MS in cases with initial diagnostic uncertainty
  1. N Mistry,
  2. J Dixon,
  3. E Tallantyre,
  4. T Jaspan,
  5. P Morgan,
  6. P Morris,
  7. N Evangelou
  1. Nottingham University Hospitals NHS Trust, UK

Abstract

Background In vivo T2*-weighted 7 Tesla (7T) MRI can be used to visualise central veins in most MS lesions (Tallantyre et al 2008). The percentage of lesions with a visible central vein reliably distinguishes patients known to have MS from patients with microangiopathic white matter brain lesions (Tallantyre et al 2011).

Objective To prospectively assess the predictive value of a single T2*-weighted 7T MRI scan, for patients that a Neurologist and Neuroradiologist could not diagnose without further paraclinical testing and follow-up.

Patients and methods Currently 20 patients have been recruited. They were undiagnosed despite assessment by a consultant Neurologist and interpretation of conventional hospital MRI scanning by a consultant Neuroradiologist. Image acquisition and analysis (blinded to clinical data) was performed using methods previously described (Tallantyre et al 2011).

Results Of the 20 patients studied, 18 have a diagnosis from their Neurologist. All 13 patients with an eventual diagnosis of demyelinating disease had central veins visible in >40% of brain lesions. All five patients with an eventual non-MS diagnosis had central veins visible in <40% of lesions. No patient with positive CSF oligoclonal bands had <40% of lesions with central veins.

Conclusion In the current cohort T2*-weighted 7T MRI had 100% positive and negative predictive value for MS. Translation of this technique to clinically available 3T MRI scanners could overhaul future diagnostic algorithms.

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Footnotes

  • Email: niraj{at}doctors.net.uk

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