When should patients be referred for advanced MRI testing to assess for CVS and PRL?

There are many pathways to an MS diagnosis that do not rely on CVS or PRL. As such, I think it is very reasonable to start with a standard brain MRI that we have been using for many years for MS diagnosis. Many patients - maybe most - will meet criteria with a standard MRI and, potentially, CSF evid...

Use of the central vein sign (CVS) and paramagnetic rim lesions (PRLs) is not required in the 2024 McDonald criteria to diagnose MS. However, when available, CVS and PRLs are useful to facilitate making the diagnosis or provide additional specificity by distinguishing MS lesions from the many other ...

At the present time, most physicians will not yet have access to advanced MRI imaging. However, if advanced MRI is available, it will be particularly useful for patients who meet have lesions in 2 or 3 characteristic locations, but have neither satisfied dissemination in time, nor have positive olig...