Neurológia pre prax 4/2023

Current recommendations for the use of MR in multiple sclerosis in clinical practice

The article presents basic imaging protocols for diagnosis and monitoring in clinical practice. A basic protocol that meets the requirements for the earliest possible diagnosis is presented, therefore, high sensitivity, but it also allows differentiation of other diseases in the differential diagnosis. Additional sequences, which are recommended in specific cases, are briefly mentioned as well. The interval and modification of the protocol in subsequent MRI is when the conditions for diagnosis are not fulfilled. The main change is that the diagnostic protocol includes not only brain but also spinal cord examination. For monitoring in clinical practice, a basic follow-up protocol and examination intervals are given. Examination with contrast agent is discussed where necessary, it is being considered when a native examination with careful MRI evaluation of active lesion is recommended. An integral part of the recommendations for the use of MRI in multiple sclerosis is the standardization of the evaluation, so that the evaluation is understandable and comparable across MS centers in the Czech Republic, which will also allow the possibility of data collection within a national registry. Finally, we will briefly mention safety monitoring.

Keywords: multiple sclerosis, magnetic resonance imaging, protocol, diagnostics, monitoring