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Abstract Details

Magnetic resonance imaging criteria at onset to differentiate pediatric multiple sclerosis from acute disseminated encephalomyelitis: A nationwide cohort study
Multiple Sclerosis
S26 - MS Imaging (1:00 PM-1:12 PM)
001
Brain MRI is the critical in distinguishing pediatric MS from ADEM. However, data on sensitivity and specificity of MRI to differentiate MS from ADEM are scarce.
To propose MRI criteria to distinguish MS from monophasic ADEM based on brain MRI and to validate previously proposed MRI criteria.  
Two neuroradiologists undertook retrospective evaluation of the MRI at the first demyelinating event in children (<18 years) with medical record-validated MS and ADEM in Denmark during 2008–15. We used forward stepwise logistic regression to identify MRI categories that differed significantly between MS and ADEM. We estimated accuracy statistics for all MRI criteria to distinguish MS from ADEM.

The monophasic ADEM cohort (n=46) was nationwide and population-based during 2008–15; the median age at onset of 5.3 years (range 0.8?17.2) and children had at least five years of follow-up to ensure a monophasic disease course. Children with MS (n=67) had a median age at onset of 16.3 years (range 3.3?17.9).

Having at least two categories best distinguished MS from monophasic ADEM by area under the curve of 83% to 89%:

(a) corpus callosum long axis perpendicular lesion; (b) only well-defined lesions; (c) absence of basal ganglia or thalamus lesion

OR

(a) only well-defined lesions; (b) corpus callosum long axis perpendicular lesion; (c) absence of diffuse large lesions; (d) black holes.

The Callen, KIDMUS, and IPMSSG criteria performed well. The McDonald 2017, Barkhof, MAGNIMS, and Verhey criteria had poorer performance.

This study provides Class II evidence that brain MRI has good performance in differentiating MS from monophasic ADEM at onset.
Authors/Disclosures
Magnus Spangsberg Boesen, MD (Herlev Hospital)
PRESENTER 		Dr. Spangsberg Boesen has nothing to disclose.
Morten B. Blinkenberg, MD, PhD (Danish MS Centre, Dept. of Neurology) The institution of Morten Bjorn Blinkenberg, MD, PhD has received research support from Danish MS Society.
No disclosure on file
Jurgita Ilginiene No disclosure on file
No disclosure on file