How accurate is imaging in diagnosis of multiple sclerosis?

Reported by Susan Aldridge, PhD, medical journalist

A review suggests that magnetic resonance imaging could give false results when it comes to diagnosis of multiple sclerosis.
The diagnosis of multiple sclerosis (MS) is often done by examining the brain with nuclear magnetic resonance (MRI) imaging. But a new analysis suggests that MRI may not be accurate enough. Researchers in Bristol, UK, looked at 29 studies dealing with MRI diagnosis of early MS. Follow up of patients lasted from a few months to 14 years – although only two followed participants up for more than ten years. These latter two suggested that the role of MRI in ruling in or ruling out MS is actually limited.

Patients with a first attack suggesting MS have around a 60 per cent probability of developing MS. If they have a positive MRI scan, the probability increases to 75 to 84 per cent. If the scan is negative, the probability decreases to 43 to 57 per cent. In other words, MRI used at the first attack of neurological dysfunction could possibly lead to over-diagnosis and over-treatment. Neurologists should discuss the very real possibility of a false positive or false negative diagnosis of MS using MRI, the researchers say.

Source
British Medical Journal online 23rd March 2006

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