This is slightly dated, but I think the info is good to share anyway:

Questions Over Accuracy of MRI in Diagnosing Multiple Sclerosis (press release)

Posted Monday, August 14, 2006 by NewsTarget, Key concepts

Questions over accuracy of MRI in diagnosing multiple sclerosis
Accuracy of magnetic resonance imaging for the diagnosis of multiple sclerosis: systematic review BMJ Online First

The accuracy of magnetic resonance imaging (MRI) is not sufficient to rule in or rule out a diagnosis of MS with a high degree of certainty, finds a study published online by the BMJ today.

MRI has been adopted in England and Wales by the National Institute for Health and Clinical Excellence (NICE) as part of the recommended criteria for diagnosing multiple sclerosis. Although its accuracy has been assessed, the evidence has not previously been systematically assessed.

Researchers analysed 29 studies to assess the accuracy of magnetic resonance imaging criteria for the early diagnosis of multiple sclerosis in patients with suspected disease. Each study compared MRI criteria to a reference standard for the diagnosis of multiple sclerosis. The average duration of follow-up ranged from seven months to 14 years.

Considerable weaknesses existed in the studies included in the review, and studies with methodological flaws overestimated the diagnostic accuracy of MRI.

Only two studies followed patients for more than 10 years, and these suggested that the role of magnetic resonance imaging either in ruling in or ruling out multiple sclerosis is limited. Patients with a first attack suggestive of MS have around a 60% probability of developing MS, this is increased to between 75 and 84% in those with a positive MRI scan and decreased to between 43 and 57% in those with a negative scan over 10-14 years.

The results suggest that use of magnetic resonance imaging to confirm multiple sclerosis on the basis of a single attack of neurological dysfunction may lead to over-diagnosis and over-treatment.

“There is a real danger of giving patients a serious diagnosis which will affect their lives but may turn out to be incorrect later on,” says Penny Whiting.

Dr Jonathan Sterne adds: “Neurologists should discuss potential consequences of false positive and false negative magnetic resonance imaging results with their patients.”

http://www.newstarget.com/019977.html

This 'smells' very much to me, as propaganda the British 'penny pinching' health system is putting out to avoid the expense of doing MRI's on suspected MS patients and thereby avoiding having to give people the CRABS!

That's an interesting way to look at it, Chez.

I guess I was thinking more along the lines of people NOT getting the proper dx of MS because the MRI didn't show enough accuracy of information.

There was a study done with that focus, and it was determined that very few lesions were visible on an MRI, in certain parts of the brain. They were able to confirm this by reviewing the MRI's (taken prior to death) to the autopsy results.

http://www.ajnr.org/cgi/content/abstract/26/3/572

Cherie

Since I am not a scientist, I don't pretend to understand most of the articles I read.

What I am looking for is how they dx the 5% of MSers who don't show lesions. I kind of wonder if it isn't more than 5%. One never sees articles on MSers who don't show lesions, just atrophy.

Limboland is he^^. Having an MS dx recinded must be much worse though. If the bathtub test was the only criteria then some of us would be out of limboland for sure.

It's long been known that no one thing on it's own really gives a dx of MS... it's a highly subjective assessment by the doctor. Hopefully research will be able to find a definitive test. I often wonder why the inhibition on the part of doctors remains in dxing not only MS but other maladies like fibromyalgia too. TC. JD

cricket,

They can give a clinical diagnosis in someone who has no lesions on MRI. I have been told that I fulfill the clinical criteria for definite MS.

A clinical diagnosis can be established if their is evidence for lesions disseminated in space and time. They tend to rely heavilly on things that aren't fakeable. They worry way too much about people faking symptoms.

My eyes, for example, show clinical evidence of lesions disseminated in space and time. I developed optic disc pallor a number of years after I developed an eye-traction problem (bilateral INO). The optic disc pallor indicates an optic nerve lesion. The eye traction indicates a brainstem lesion. So, there are lesions in two different locations, and they happened at different times.

There is a lot of caution out there against giving a definite diagnosis to someone in whom all of the tests have been negative. It's really up to the doctor what tests they need to show positive for a definite diagnosis if the person has shown clinical evidence of lesions disseminated in space and time.

This hasn't been the first article I've read about the uncertainty of MRIs when diagnosing MS. I don't think for one minute it's propaganda but simply scientific fact.

Harry