Evidence map›Paper›PMID 40349257›Full record

ArticleJournal of neurology2025

Clinical integration of brain and cord MRI features improves differential diagnosis of multiple sclerosis.

Maria A Rocca, Sophia Ratzinger, Paolo Preziosa, Alessandro Meani, Mor Gueye, Paolo Vezzulli, Elisabetta Pagani, Federica Esposito, Antonino Giordano, Bruno Colombo and 2 more

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Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Maria A RoccaNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. rocca.mara@hsr.it.ORCID http://orcid.org/0000-0003-2358-4320
Sophia RatzingerNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Paolo PreziosaNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Alessandro MeaniNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Mor GueyeNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Paolo VezzulliNeuroradiology Unit and High Field MRI Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Elisabetta PaganiNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Federica EspositoNeurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Antonino GiordanoNeurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Bruno ColomboNeurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Andrea FaliniVita-Salute San Raffaele University, Milan, Italy.
Massimo FilippiNeuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo explore the role of brain and spinal cord MRI features in differentiating patients with suspected central nervous system (CNS) inflammatory diseases. MATERIAL AND

methodsProspective data from 125 patients undergoing diagnostic evaluation, including 1.5 T brain and spinal cord MRI scans from February 2021 and March 2024 were analyzed. The cohort comprised 91 patients with multiple sclerosis (MS), 15 with other inflammatory neurological diseases (OIND), and 19 with non-inflammatory neurological diseases (NIND). Brain and spinal cord lesion topographies and morphological features were evaluated to identify MRI features discriminating MS from OIND and NIND.

resultsRandom forest analysis identified key MRI features supporting MS diagnosis over OIND: absence of longitudinally extensive transverse myelitis (relative importance [RI] = 100%), presence of ≥ 1 Dawson's finger (RI = 55.3%), ≥ 1 cortical lesion (RI = 42.6%), and ≥ 1 brain T2-hyperintense white matter (WM) lesion (RI = 36.4%). After excluding the presence of ≥ 1 brain T2-hyperintense WM lesion, fulfilling  ≥  2 of the 3 selected criteria distinguished MS from OIND patients with a sensitivity of 0.59 and a specificity of 0.80. For distinguishing MS from NIND, relevant MRI features included ≥ 1 T2-hyperintense spinal cord lesion (RI = 100.0%), ≥ 1 Dawson's finger (RI = 84.3%), ≥ 1 cortical lesion (RI = 61.4%), ≥ 1 cerebellar peduncle lesion (RI = 52.2%) and ≥ 3 central vein sign-positive lesions (RI = 27.8%). Fulfilling ≥ 2 of the 5 selected criteria identified MS patients with a sensitivity of 0.64 and a specificity of 0.84.

conclusionIntegrating specific MRI features in the diagnostic work-up of patients with suspected CNS inflammatory disease improves differentiation between MS, OIND, and NIND, reducing the risk of misdiagnosis.

Indexed as

BrainMagnetic Resonance ImagingMultiple SclerosisNeuroinflammatory DiseasesSpinal CordAdultAgedDiagnosis, DifferentialFemaleHumansMaleMiddle AgedProspective StudiesSensitivity and SpecificityYoung AdultCentral vein signCortical lesionsDifferential diagnosisMRIMultiple sclerosisParamagnetic rim lesionsSpinal cord

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.