Efficiency of MRI in Detecting and Diagnosing Multiple Sclerosis: A Retrospective Study

Abstract

Background: Multiple sclerosis (MS) is a chronic, autoimmune, neurodegenerative disease of the central nervous system, primarily affecting the brain and spinal cord. Prevalence has increased significantly in many regions since 1990, especially in various low- and middle-income countries, imposing a significant economic and healthcare burden. This study aimed to assess the efficiency of MRI in detecting and diagnosing MS. Methods and Results: Our single-center retrospective study reviewed the records of 48 MS patients (13 males and 35 females) at King Fahad Hospital between January 1, 2022, and October 30, 2022. MRI findings and patients' demographic information during diagnosis were reviewed and collected. The McDonald criteria (2017) for the diagnosis of MS were applied. Most of the patients were 26-35 years old (43.8%), followed by those aged between 36 and 45. The weight distribution in this study showed that 35.4% of patients weighed 87–102 kg, 27% 71–86 kg, 23% 55–70 kg, and 14.6% 39–54 kg, suggesting that more than 60% of patients were overweight. The most affected areas were in the brain (64.6%), while the spinal cord was affected in 31.2% and the brain and spinal cord in 4.2%. Most of the MRI findings were expanding lesions (25%) and dark spots (25%), followed by plaques (18.8%), ring lesions (18.8%), and bright spots (12.5%). Clinical signs varied among patients and included optic neuritis (27.1%), difficulty walking (14.6%), cervicalgia (14.6%), facial pain (10.4%), blurred vision (10.4%), hemiplegia (8.3%), and chronic headache (8.3%). Optic neuritis was more often accompanied by dark (38.5%) and bright (23.1%) spots, but neck pain by expanding lesions (57.0%). Overall, dark spots and expanding lesions represented the most disease features (25.0% each), followed by plaques and ring lesions (18.8% each), and the last was bright spots (12.5%). Conclusion: Clinical signs vary among MS patients, with most of the symptoms related to the optic nerve (optic neuritis or blurred vision) and affected musculoskeletal conditions, which include difficulty walking and hemiplegia. MRI has an important role in detecting and diagnosing MSA. Most of the MRI findings are expanding lesions and dark spots, followed by plaques, ring lesions, and bright spots.

Keywords

• multiple sclerosis
• mri
• optic neuritis