Abstract
Background: Multiple sclerosis (MS) is an autoimmune, inflammatory, demyelinating and degenerative disease of the central nervous system (CNS). To date, there is no definitive imaging biomarker for diagnosing MS. The current diagnostic criteria are mainly based on clinical relapses supported by the presence of white matter lesions (WMLs) on MRI. However, misdiagnosis of MS is still a significant clinical problem. The paramagnetic, iron rims (IRs) around white matter lesions have been proposed to be an imaging biomarker in MS. This study aimed to carry out a systematic mapping review to explore the detection of iron rim lesions (IRLs), on clinical MR scans, and describe the characteristics of IRLs presence in MS versus other MS-mimic disorders. Methods: Publications from 2001 on IRs lesions were reviewed in three databases: PubMed, Web of Science and Embase. From the initial result set 718 publications, a final total of 38 papers were selected. Results: The study revealed an increasing interest in iron/paramagnetic rims lesions studies. IRs were more frequently found in periventricular regions and appear to be absent in MS-mimics. Conclusions IR is proposed as a promising imaging biomarker for MS.
Highlights
Multiple sclerosis (MS) is an autoimmune, inflammatory, demyelinating and degenerative disease of the central nervous system (CNS) [1]
Different prevalence was reported of iron rim lesions (IRLs); the prevalence was calculated from the included studies based on lesions and patients counts
The lesion volume of iron rims (IRs) showed a gradual increase in size and fusion with neighboring IR lesions within 3.5 years, and this was proven on both 3T and 7T studies
Summary
Multiple sclerosis (MS) is an autoimmune, inflammatory, demyelinating and degenerative disease of the central nervous system (CNS) [1] It is associated with focal inflammatory demyelinating lesions in both white and grey matter [2]. There is no established and uniformly used imaging biomarker for diagnosing MS, and the diagnostic criteria are based mainly on clinical relapses and the presence of lesions on MRI and oligoclonal bands in the cerebrospinal fluid. The current diagnostic criteria are mainly based on clinical relapses supported by the presence of white matter lesions (WMLs) on MRI. The paramagnetic, iron rims (IRs) around white matter lesions have been proposed to be an imaging biomarker in MS. Methods: Publications from 2001 on IRs lesions were reviewed in three databases: PubMed, Web of Science and Embase
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