2010 McDonald MRI Criteria for Diagnosis of Multiple Sclerosis

Diagnosis of Multiple Sclerosis (MS)

• Clinical + paraclinical lab assessment
• Need to demonstrate dissemination of lesions in space (DIS) and time (DIT), and exclude other diagnoses
• Since the last McDonald Criteria (2005-version), new data and consensus have agreed upon simplification of the criteria to improve comprehension and utility
• McDonald Criteria should only be applied in patients presenting with a typical clinically isolated syndrome suggestive of MS, or symptoms consistent with a CNS inflammatory demyelinating disease
• Clinical isolated syndrome typically involve the optic nerve, brainstem/cerebellum, spinal cord or cerebral hemispheres; can be monofocal or multifocal

MR Imaging Criteria for DIS / DIT

• At least one T2 lesion in at least 2 of 4 locations considered characteristic for MS (juxtacortical, periventricular, infratentorial, and spinal cord)
• A new T2 and/or gadolinium-enhancing lesion(s) on follow-up MRI, with reference to a baseline scan, irrespective of the timing of the baseline MRI
• Simultaneous presence of asymptomaatic gadolinium-enhancing and nonenhancing lesions at any time

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Reference:

Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald Criteria. Ann Neurol 2011;69 (first published online 8 Mar 2011)