TY - JOUR

T1 - Magnetic resonance imaging criteria at onset to differentiate pediatric multiple sclerosis from acute disseminated encephalomyelitis

T2 - A nationwide cohort study

AU - Boesen, Magnus Spangsberg

AU - Blinkenberg, Morten

AU - Thygesen, Lau Caspar

AU - Ilginiene, Jurgita

AU - Langkilde, Annika Reynberg

PY - 2022

Y1 - 2022

N2 - Background: MRI of the nervous system is the critical in distinguishing pediatric MS from acute disseminated encephalomyelitis (ADEM). Our aim was to propose MRI criteria to distinguish MS from monophasic ADEM based on the first MRI and to validate previously proposed MRI criteria.Methods: A neuroradiologist undertook retrospective evaluation of the MRI at the first demyelinating event in children (Results: The monophasic ADEM cohort (n=46) was nationwide and population-based during 2008-15; the me-dian age at onset of 5.3 years (range 0.8-17.2) and children had at least five years of follow-up to ensure a monophasic disease course. Children with MS (n=67) had a median age at onset of 16.3 years (range 3.3-17.9). Having at least two categories best distinguished MS from monophasic ADEM by an area under the curve of 83% to 89%: (a) corpus callosum long axis perpendicular lesion; (b) only well-defined lesions; (c) absence of basal ganglia or thalamus lesion OR, (a) corpus callosum long axis perpendicular lesion; (b) only well-defined lesions; (c) absence of diffuse large lesions; (d) black holes. The Callen, KIDMUS, and IPMSSG criteria performed well. The McDonald 2017, Barkhof, MAGNIMS, and Verhey criteria had poorer performance.Conclusion: This study provides Class II evidence that MRI has good performance in differentiating MS from monophasic ADEM at onset.

AB - Background: MRI of the nervous system is the critical in distinguishing pediatric MS from acute disseminated encephalomyelitis (ADEM). Our aim was to propose MRI criteria to distinguish MS from monophasic ADEM based on the first MRI and to validate previously proposed MRI criteria.Methods: A neuroradiologist undertook retrospective evaluation of the MRI at the first demyelinating event in children (Results: The monophasic ADEM cohort (n=46) was nationwide and population-based during 2008-15; the me-dian age at onset of 5.3 years (range 0.8-17.2) and children had at least five years of follow-up to ensure a monophasic disease course. Children with MS (n=67) had a median age at onset of 16.3 years (range 3.3-17.9). Having at least two categories best distinguished MS from monophasic ADEM by an area under the curve of 83% to 89%: (a) corpus callosum long axis perpendicular lesion; (b) only well-defined lesions; (c) absence of basal ganglia or thalamus lesion OR, (a) corpus callosum long axis perpendicular lesion; (b) only well-defined lesions; (c) absence of diffuse large lesions; (d) black holes. The Callen, KIDMUS, and IPMSSG criteria performed well. The McDonald 2017, Barkhof, MAGNIMS, and Verhey criteria had poorer performance.Conclusion: This study provides Class II evidence that MRI has good performance in differentiating MS from monophasic ADEM at onset.

KW - Magnetic resonance imaging

KW - Acute disseminated encephalomyelitis

KW - Multiple sclerosis

KW - Pediatric

KW - MRI CRITERIA

KW - PROGNOSTIC-FACTORS

KW - DANISH

KW - DEMYELINATION

KW - DIAGNOSIS

KW - REVISIONS

KW - SYSTEM

KW - HEALTH

KW - ADEM

U2 - 10.1016/j.msard.2022.103738

DO - 10.1016/j.msard.2022.103738

M3 - Journal article

C2 - 35452961

VL - 62

JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

SN - 2211-0348

M1 - 103738

ER -