Magnetic resonance imaging at baseline and follow-up to differentiate between pediatric monophasic acquired CNS demyelination and MS.

Child Encephalomyelitis, Acute Disseminated / diagnostic imaging Follow-Up Studies Humans Magnetic Resonance Imaging Multiple Sclerosis / diagnostic imaging Retrospective Studies
Acute disseminated encephalomyelitis Children Magnetic resonance imaging Multiple sclerosis Pediatrics

Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 12 07 2020
revised: 16 10 2020
accepted: 19 10 2020
pubmed: 11 12 2020
medline: 15 5 2021
entrez: 10 12 2020
Statut: ppublish

Résumé

It is essential to distinguish acute disseminated encephalomyelitis (ADEM) from MS early. Our aim was to determine MRI features at baseline and follow-up to distinguish pediatric ADEM from MS stratified according to age at onset. Using hospital ICD-10 codes for acquired demyelinating syndromes from a nationwide register and subsequent chart review, we identified 52 children (<18 years) with ADEM and 66 children with MS. We undertook a retrospective analysis of MRI scans at onset and at follow-up. The MRI rater was a senior neuroradiologist blinded to clinical characteristics. At baseline, children with ADEM had more diffuse poorly demarcated lesions, particularly in the basal ganglia/thalamus (p = 0.001) and cerebellar peduncles (p < 0.0001). Further, longitudinal extensive transverse myelitis was strongly associated with ADEM (p<0.0001). Children with ADEM had fewer contrast-enhancing lesions (p = 0.0004), occipital lesions (p = 0.01), optic nerve lesions (p = 0.01), periventricular lesions, well-defined lesions only (p<0.0001), and fewer fulfilled dissemination in time according to the McDonald 2017 criteria (p = 0.005). On baseline MRI, dissemination in space and time was fulfilled in 17% of children with ADEM and in 34% of children with MS (p = 0.06), and 60% of children with ADEM fulfilled the criterion for dissemination in space. The mean time from baseline MRI to follow-up MRI was 1.0 year for children with ADEM and 2.1 years for children with MS. On follow-up MRI, 85% of children with ADEM had partial or complete T2 lesion resolution, but in the 58% without complete resolution lesions were predominantly frontal. Only 47% of children with MS had partial or complete T2 lesion resolution, and therefore more MRI features differed between children with ADEM and MS on follow-up. MRI had the greatest distinguishing value after age 11 years because MS is exceptional in the first decade of life. Age at onset and the timing of MRI in relation to disease onset are critical in the interpretation of MRI to distinguish between ADEM and MS.

Sections du résumé

BACKGROUND BACKGROUND
It is essential to distinguish acute disseminated encephalomyelitis (ADEM) from MS early. Our aim was to determine MRI features at baseline and follow-up to distinguish pediatric ADEM from MS stratified according to age at onset.
METHODS METHODS
Using hospital ICD-10 codes for acquired demyelinating syndromes from a nationwide register and subsequent chart review, we identified 52 children (<18 years) with ADEM and 66 children with MS. We undertook a retrospective analysis of MRI scans at onset and at follow-up. The MRI rater was a senior neuroradiologist blinded to clinical characteristics.
RESULTS RESULTS
At baseline, children with ADEM had more diffuse poorly demarcated lesions, particularly in the basal ganglia/thalamus (p = 0.001) and cerebellar peduncles (p < 0.0001). Further, longitudinal extensive transverse myelitis was strongly associated with ADEM (p<0.0001). Children with ADEM had fewer contrast-enhancing lesions (p = 0.0004), occipital lesions (p = 0.01), optic nerve lesions (p = 0.01), periventricular lesions, well-defined lesions only (p<0.0001), and fewer fulfilled dissemination in time according to the McDonald 2017 criteria (p = 0.005). On baseline MRI, dissemination in space and time was fulfilled in 17% of children with ADEM and in 34% of children with MS (p = 0.06), and 60% of children with ADEM fulfilled the criterion for dissemination in space. The mean time from baseline MRI to follow-up MRI was 1.0 year for children with ADEM and 2.1 years for children with MS. On follow-up MRI, 85% of children with ADEM had partial or complete T2 lesion resolution, but in the 58% without complete resolution lesions were predominantly frontal. Only 47% of children with MS had partial or complete T2 lesion resolution, and therefore more MRI features differed between children with ADEM and MS on follow-up. MRI had the greatest distinguishing value after age 11 years because MS is exceptional in the first decade of life.
CONCLUSION CONCLUSIONS
Age at onset and the timing of MRI in relation to disease onset are critical in the interpretation of MRI to distinguish between ADEM and MS.

Identifiants

DOI: 10.1016/j.msard.2020.102590 PMID: 33296986
pubmed: 33296986
pii: S2211-0348(20)30664-7
doi: 10.1016/j.msard.2020.102590
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102590

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Magnus Spangsberg Boesen (MS)

Department of Pediatrics, Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology, Herlev Hospital, Denmark. Electronic address: magnus.spangsberg.boesen@regionh.dk.

Morten Blinkenberg (M)

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: morten.blinkenberg@regionh.dk.

Alfred Peter Born (AP)

Department of Pediatrics, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: alfred.peter.born@regionh.dk.

Melinda Magyari (M)

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; The Danish Multiple Sclerosis Registry, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: melinda_magyari@dadlnet.dk.

Tanuja Chitnis (T)

Partners Pediatric Multiple Sclerosis Center at the Massachusetts General Hospital for Children, Boston, MA, USA. Electronic address: tchitnis@rics.bwh.harvard.edu.

Lau Caspar Thygesen (LC)

National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. Electronic address: lct@si-folkesundhed.dk.

Annika Reynberg Langkilde (AR)

Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Electronic address: annika.Langkilde@regionh.dk.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Magnetic resonance imaging at baseline and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › Troubles post-infectieux › Encéphalomyélite aigüe disséminée › Magnetic resonance imaging at baseline and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Magnetic resonance imaging at baseline and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Magnetic resonance imaging at baseline and...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › Magnetic resonance imaging at baseline and...
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questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Magnetic resonance imaging at baseline and...