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MRI has been formally included in the diagnostic work-up of patients with a suspicion of multiple sclerosis (MS) in 2001, to demonstrate disease dissemination in space (DIS) and time (DIT) and to exclude alternative diagnoses.1 Over time, these criteria have been modified to simplify their use and to clarify specific aspects (eg, spinal cord findings).2
One aspect marginally analysed in the diagnostic work-up of patients with clinically isolated syndrome (CIS) is the role of intracortical lesions (ICLs), which are a prominent feature of MS and contribute to disability and cognitive impairment.2 A single-centre study3 showed that inclusion of ICL for the evaluation of DIS in CIS increased the accuracy of MRI diagnostic criteria, with an improvement of specificity.3
The aim of this study was to compare revised McDonald-20101 and Filippi-20103 criteria with respect to development of clinically definite MS (CDMS) in a multicentric cohort of patients with CIS.
Institutional review board approval and written informed consent were obtained.
Consecutive patients with CIS suggestive of MS were prospectively recruited from 2008 to 2013 from five European centres within the MAGNIMS network (http://www.magnims.eu/) (see online supplementary file 1, Supplementary Methods).
Inclusion criteria were a typical CIS syndrome, exclusion of alternative diagnoses and previous events, a baseline brain (including double inversion recovery (DIR)) and spinal cord MRI scan acquired ≤3 months from CIS onset, a follow-up brain scan acquired ≤12 months from CIS onset and a clinical follow-up ≥3 years or until CDMS conversion (defined as occurrence of a second relapse ≥1 month after the first attack) if ≤3 years.
MRI acquisition and analysis
Using 1.5 (two centres) or 3.0 Tesla (three centres) scanners, brain (including DIR) and spinal cord sequences for lesion identification were acquired. Online supplementary material shows parameters and examples of MRI …
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