Journal
ARQUIVOS DE NEURO-PSIQUIATRIA
Volume 71, Issue 9B, Pages 738-746Publisher
ASSOC ARQUIVOS NEURO- PSIQUIATRIA
DOI: 10.1590/0004-282X20130162
Keywords
central nervous system infections; multiple sclerosis; differential diagnosis; magnetic resonance imaging; MRI
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The current diagnostic criteria for multiple sclerosis (MS) confirm the relevant role of magnetic resonance imaging (MRI), supporting the possibility of characterizing the dissemination in space (DIS) and the dissemination in time (DIT) in a single scan. To maintain the specificity of these criteria, it is necessary to determine whether T2/FLAIR visible lesions and the gadolinium enhancement can be attributed to diseases that mimic MS. Several diseases are included in the MS differential diagnosis list, including diseases with exacerbation, remitting periods and numerous treatable infectious diseases, which can mimic the MRI features of MS. We discuss the most relevant imaging features in several infectious diseases that resemble MS and examine the primary spatial distributions of lesions and the gadolinium enhancement patterns related to MS. Recognizing imaging red flags can be useful for the proper diagnostic evaluation of suspected cases of MS, facilitating the correct differential diagnosis by assessing the combined clinical, laboratory and MR imaging information.
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