MRI red flags proposed over a decade ago by the European Magnetic Resonance Network in MS (MAGNIMS) have guided clinicians in the diagnosis of multiple sclerosis (MS). However, the past 10 years have seen increased recognition that vascular disease can coexist and possibly interact with MS, improvements in the reliability of ways to differentiate MS from novel antibody-mediated CNS disorders (such as anti-aquaporin-4 antibody and myelin-oligodendrocyte glycoprotein antibody-associated diseases) and advances in MRI techniques. In this Review, MAGNIMS updates the imaging features that differentiate the most common mimics of MS, particularly age-related cerebrovascular disease and neuromyelitis optica, from MS itself. We also provide a pragmatic summary of the clinically useful MRI features that distinguish MS from its mimics and discuss the future of nonconventional techniques that have identified promising disease-specific features.

欧洲磁共振网络（MSNIMS）十多年前提出的MRI危险信号已指导临床医生诊断多发性硬化症（MS）。然而，在过去的十年中，人们越来越认识到血管疾病可以与MS共存并可能与MS相互作用，从而将MS与新型抗体介导的中枢神经系统疾病（例如抗水通道蛋白4抗体和髓磷脂少突胶质细胞）区别开来的方法的可靠性得到了提高糖蛋白抗体相关疾病）和MRI技术的进步。在本综述中，MAGNIMS更新了影像学功能，以区分MS最常见的模拟物，特别是年龄相关性脑血管疾病和视神经脊髓炎，与MS本身有所区别。