2021 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis,The Lancet Neurology

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2021 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis
The Lancet Neurology ( IF 46.5 ) Pub Date : 2021-06-14 , DOI: 10.1016/s1474-4422(21)00095-8
Mike P Wattjes ₁ , Olga Ciccarelli ₂ , Daniel S Reich ₃ , Brenda Banwell ₄ , Nicola de Stefano ₅ , Christian Enzinger ₆ , Franz Fazekas ₇ , Massimo Filippi ₈ , Jette Frederiksen ₉ , Claudio Gasperini ₁₀ , Yael Hacohen ₁₁ , Ludwig Kappos ₁₂ , David K B Li ₁₃ , Kshitij Mankad ₁₄ , Xavier Montalban ₁₅ , Scott D Newsome ₁₆ , Jiwon Oh ₁₇ , Jacqueline Palace ₁₈ , Maria A Rocca ₁₉ , Jaume Sastre-Garriga ₂₀ , Mar Tintoré ₂₀ , Anthony Traboulsee ₂₁ , Hugo Vrenken ₂₂ , Tarek Yousry ₂₃ , Frederik Barkhof ₂₄ , Àlex Rovira ₂₅ , , ,

Affiliation

Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands.
Faculty of Brain Sciences, University College London Queen Square Institute of Neurology, University College London, London, UK; National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK.
Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Department of Neurology, Medical University of Graz, Graz, Austria.
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Glostrup, Denmark.
Department of Neurology, San Camillo-Forlanini Hospital, Roma, Italy.
Faculty of Brain Sciences, University College London Queen Square Institute of Neurology, University College London, London, UK; Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK.
Department of Neurology and Research Center for Clinical Neuroimmunology and Neuroscience, University Hospital of Basel and University of Basel, Basel, Switzerland.
Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK.
Multiple Sclerosis Centre of Catalonia, Department of Neurology-Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Division of Neurology, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Division of Neurology, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Nuffield Department of Clinical Neurosciences, Oxford, UK.
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Multiple Sclerosis Centre of Catalonia, Department of Neurology-Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Division of Neurology, University of British Columbia, Vancouver, BC, Canada.
Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands.
Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, London, UK; Neuroradiological Academic Unit, University College London Queen Square Institute of Neurology, University College London, London, UK.
Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands; Faculty of Brain Sciences, University College London Queen Square Institute of Neurology, University College London, London, UK; National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK.
Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

The 2015 Magnetic Resonance Imaging in Multiple Sclerosis and 2016 Consortium of Multiple Sclerosis Centres guidelines on the use of MRI in diagnosis and monitoring of multiple sclerosis made an important step towards appropriate use of MRI in routine clinical practice. Since their promulgation, there have been substantial relevant advances in knowledge, including the 2017 revisions of the McDonald diagnostic criteria, renewed safety concerns regarding intravenous gadolinium-based contrast agents, and the value of spinal cord MRI for diagnostic, prognostic, and monitoring purposes. These developments suggest a changing role of MRI for the management of patients with multiple sclerosis. This 2021 revision of the previous guidelines on MRI use for patients with multiple sclerosis merges recommendations from the Magnetic Resonance Imaging in Multiple Sclerosis study group, Consortium of Multiple Sclerosis Centres, and North American Imaging in Multiple Sclerosis Cooperative, and translates research findings into clinical practice to improve the use of MRI for diagnosis, prognosis, and monitoring of individuals with multiple sclerosis. We recommend changes in MRI acquisition protocols, such as emphasising the value of three dimensional-fluid-attenuated inversion recovery as the core brain pulse sequence to improve diagnostic accuracy and ability to identify new lesions to monitor treatment effectiveness, and we provide recommendations for the judicious use of gadolinium-based contrast agents for specific clinical purposes. Additionally, we extend the recommendations to the use of MRI in patients with multiple sclerosis in childhood, during pregnancy, and in the post-partum period. Finally, we discuss promising MRI approaches that might deserve introduction into clinical practice in the near future.

中文翻译：

2021 年 MAGNIMS–CMSC–NAIMS 关于在多发性硬化患者中使用 MRI 的共识建议

2015 年多发性硬化症磁共振成像和 2016 年多发性硬化症中心联盟关于使用 MRI 诊断和监测多发性硬化症的指南为在常规临床实践中适当使用 MRI 迈出了重要一步。自颁布以来，相关知识取得了重大进展，包括 2017 年麦当劳诊断标准的修订、对静脉注射钆造影剂的新安全问题以及脊髓 MRI 在诊断、预后和监测方面的价值。这些进展表明 MRI 在多发性硬化患者管理中的作用正在发生变化。这份 2021 年修订的先前多发性硬化症患者使用 MRI 指南合并了多发性硬化症研究组、多发性硬化症中心联盟和北美多发性硬化症成像合作组织的磁共振成像建议，并将研究结果转化为临床实践改进 MRI 在多发性硬化患者诊断、预后和监测中的应用。我们建议改变 MRI 采集协议，例如强调三维流体衰减反转恢复作为核心脑脉冲序列的价值，以提高诊断准确性和识别新病变以监测治疗效果的能力，我们为明智的人提供建议为特定临床目的使用钆造影剂。此外，我们将建议扩展到儿童期、怀孕期间和产后多发性硬化症患者中使用 MRI。最后，我们讨论了可能值得在不久的将来引入临床实践的有前景的 MRI 方法。

更新日期：2021-07-22

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