MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process
Open accessAbstract
The use of MRI in patients with multiple sclerosis (MS) is commonplace in clinical settings. However, the precise implementation of MRI in the diagnosis of MS is highly variable, which is problematic in the context of the substantial technical advances of the past decade. In these Evidence-based Guidelines, members of the MAGNIMS study group present a standardized approach to the use of MRI in the diagnosis of MS. The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.
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Development of the McDonald Criteria was largely based on data from adult Caucasian European and North American populations with a typical CIS and age less than 50 years.
“Development of the McDonald Criteria was largely based on data from adult Caucasian European and North American populations with a typical CIS 14 and age less than 50 years.”
From Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria (2018) · cites this paper as [14]
The Discussion (page not provided) says the 2010 McDonald revisions were partly based on findings in white European adults, and the recommendations discuss applying the criteria to patients with CIS. Our copy does not establish that development was largely based on these data, or specify North American populations, a typical CIS, or an age limit below 50 years. (LLM, conf=0.84)
Experimental — accuracy not yet measuredA post-contrast T1-weighted scan is recommended in patients with brain MRI lesions, to assist in diagnosis and differential diagnosis.
“A post-contrast T1-weighted scan is recommended in patients with brain MRI lesions, to assist in diagnosis and differential diagnosis.12”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
Spinal cord MRI is recommended in patients with myelopathy or when MRI brain findings are not diagnostic of MS.
“Spinal cord MRI is recommended in patients with myelopathy or when MRI brain findings are not diagnostic of MS. 12”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
In addition to obtaining brain images with an axial orientation, a sagittal T2 FLAIR sequence is recommended for detecting juxtacortical and corpus callosum lesions, which can be helpful in differentiating MS from other disorders.
“In addition to obtaining brain images with an axial orientation, a sagittal T2 fluid-attenuated inversion recovery (FLAIR) sequence is recommended for detecting juxtacortical and corpus callosum lesions, which can be helpful in differentiating MS from other disorders.12,13”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
A standardised MRI protocol was recently proposed by the MAGNIMS network to assist in the diagnosis of MS.
“A standardised MRI protocol was recently proposed by the MAGNIMS network to assist in the diagnosis of MS. 12”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
Current guidelines recommend a post-contrast T1-weighted scan as part of the diagnostic evaluation of patients with suspected MS.
“Current guidelines recommend a post-contrast T1weighted scan as part of the diagnostic evaluation of patients with suspected MS. 12”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
Gadolinium-enhancing lesions provide evidence for dissemination in time and can also assist in differential diagnosis.
“Gadolinium-enhancing lesions provide evidence for dissemination in time and can also assist in differential diagnosis.1,12”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
Current guidelines recommend spinal cord MRI in patients with symptoms of myelopathy or when brain MRI findings are not diagnostic of MS.
“Current guidelines recommend spinal cord MRI in patients with symptoms of myelopathy or when brain MRI findings are not diagnostic of MS. 12”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
Cortical grey matter is frequently involved in MS pathologically.
“Cortical grey matter is frequently involved in MS pathologically”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [12]
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Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria
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Self-citationDiagnosis of multiple sclerosis: progress and challenges
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- Authors
- on behalf of the MAGNIMS study group, Rovira, À., Wattjes, M. P., Tintoré, M., Tur, C., Yousry, T. A., Sormani, M. P., De Stefano, N., Filippi, M., Auger, C., Rocca, M. A., Barkhof, F., Fazekas, F., Kappos, L., Polman, C., Miller, D., & Montalban, X.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- University College London Hospitals NHS Foundation Trust (GB)
- University of Siena (IT)
- Vita-Salute San Raffaele University (IT)
- Medical University of Graz (AT)
- University of Basel (CH)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Rovira, Àlex
- ORCID
- Venue
- Nature Reviews Neurology
- Published
- 2015-07-07
- Volume
- 11
- Issue
- 8
- Pages
- 471-482
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- OpenAlex
- W1943838624
- Cited by
- 423
- References
- 4
- Citations by year
- 2026: 18 · 2025: 24 · 2024: 20 · 2023: 26 · 2022: 39 · 2021: 63 · 2020: 36 · 2019: 41 · 2018: 55 · 2017: 56 · 2016: 37 · 2015: 7 · 2014: 1
- FWCI
- 7.65
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nature Reviews Neurology (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0508-10058)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Keywords
- multiple sclerosis, magnetic resonance imaging, MS diagnosis, clinical implementation, MRI indications, MRI reporting, MRI interpretation, brain MRI, spinal cord MRI
- MeSH terms
- Brain Diseases, Clinical Protocols, Contrast Media, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Medical Records, Multiple Sclerosis, Spinal Cord Diseases, Evidence-Based Medicine, Consensus
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