Recommendations for communication
| Recommendations |
|---|
| The clinical requisition for brain MRI should include |
| Requesting the CMSC or standardized brain MRI protocol |
| Indicating the purpose of the study |
| Diagnostic study for CIS or MS (indicate date of symptom onset) |
| Treatment-monitoring study (indicate if on disease-modifying therapy) |
| PML surveillance study (indicate if high- or low-risk) |
| Unexpected clinical decline or reassessment of diagnosis |
| Date and location of most recent MRI study (encourage patient to bring a copy of outside images on portable media at the time of MRI appointment) |
| The radiology report should include |
| For a diagnostic MS study |
| Number of gadolinium-enhancing T1 lesions (eg, 0, 1, 2, 3, 4, ≥5) |
| Comparison with previous studies for the number of new T2 lesions (eg, 0, 1, 2, 3, 4, ≥5) |
| The presence of juxtacortical (touching the cortex), periventricular (touching the ventricles), infratentorial, or spinal cord lesions |
| The report should avoid a summary statement like “McDonald diagnostic criteria met” |
| The interpretation should indicate whether findings are typical, atypical, or not consistent with MS and should provide a differential diagnosis if appropriate |
| For a follow-up MS study |
| Number of gadolinium-enhancing T1 lesions (eg, 0, 1, 2, 3, 4, ≥5) |
| Comparison with previous studies for the number of new T2 lesions (eg, 0, 1, 2, 3, 4, ≥5) |
| Qualitative assessment of |
| Overall T2 lesion-burden severity (eg, mild, moderate, severe) |
| Comparison with previous studies for overall worsening of T2 lesion burden and atrophy |
| For a PML surveillance study |
| Comparison with previous studies for new T2 lesions, hyperintense lesions on DWI |
| Presence of PML suspicious features |