Mayo Clinic Arizona
Neurology

Author Of 1 Presentation

Imaging Poster Presentation

P0660 - Yield and potential value of spinal cord MRI surveillance in treated relapsing multiple sclerosis   (ID 1496)

Presentation Number
P0660
Presentation Topic
Imaging

Abstract

Background

Periodic brain magnetic resonance imaging (MRI) monitoring is recommended to assess subclinical disease activity in patients with multiple sclerosis (MS) who are on disease modifying therapies (DMTs). However, it is unclear whether spinal cord MRI surveillance is also useful.

Objectives

To determine how frequently follow-up MRI of the cervical or thoracic spine revealed asymptomatic new (T2 hyperintense or T1 gadolinium-enhancing) lesions in patients with MS on DMTs.

Methods

This was a retrospective medical record review. Patients with relapsing MS aged 18–60 years, on DMT, with MRI of the brain, cervical and thoracic spine, seen in our MS clinic in the past 5 years were included.

Results

One hundred and ten patients were included. Seventy-four percent were female and 92% were Caucasian. Median age at MS diagnosis was 37 years (range 19-56) and the median disease duration at the time of first MRI in the study was 0.7 years (range 0-20). Median follow up time was 3 years (range 1- 10). At least one new asymptomatic lesion was detected in the brain MRI in 31% of the patients. Nine patients (8%) developed at least one new asymptomatic cervical cord lesion. None developed asymptomatic new lesions in the thoracic spine.

Conclusions

A small proportion of patients developed asymptomatic cervical cord lesions and none of the patients developed asymptomatic thoracic lesions. Given that spinal cord lesions are associated with worse prognosis in the first years after MS diagnosis, cervical spine MRI might be useful in surveying asymptomatic new lesions, but thoracic spinal cord MRI does not appear to add significant value to MS monitoring.

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