BMJ  2006;332:1034 (29 April), doi:10.1136/bmj.332.7548.1034-a

Letter

Role of MRI in diagnosing multiple sclerosis

Magnetic resonance imaging is valuable

The first 150 words of the full text of this article appear below.

EDITOR—In investigating the diagnostic utility of magnetic resonance imaging (MRI) in cases of suspected multiple sclerosis, Whiting et al have evaluated imaging findings reported in many different studies—mainly whether there are any lesions present in a brain scan.1 This approach does not reflect real life, where neurologists use a more detailed interpretation of MRI abnormalities in the context of the clinical findings to reach a diagnosis. Clinicians deal with many different clinical settings that make the diagnosis of multiple sclerosis more or less likely and also have to consider the differential diagnosis. An early and reliable diagnosis facilitates best management and alleviates anxiety due to diagnostic uncertainty. While the diagnosis of multiple sclerosis is based primarily on clinical manifestations, it is often helpfully—and sometimes crucially—supported by laboratory investigations. When used appropriately, MRI—and sometimes cerebrospinal fluid and neurophysiological (evoked potentials) examination—improves diagnostic accuracy and helps exclude or identify other . . . [Full text of this article]

David H Miller, professor of clinical neurology

Institute of Neurology, University College London, London WC1N 3BG d.miller@ion.ucl.ac.uk


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Relevant Article

Accuracy of magnetic resonance imaging for the diagnosis of multiple sclerosis: systematic review
Penny Whiting, Roger Harbord, Caroline Main, Jonathan J Deeks, Graziella Filippini, Matthias Egger, and Jonathan A C Sterne
BMJ 2006 332: 875-884. [Abstract] [Full Text] [PDF]

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