Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society.

Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care.

Recurrent varicocele. Demonstration by 3D phase-contrast MR angiography.

This is a report on an initial experience with Gd-enhanced 3D phase-contrast MR angiography in 4 patients with recurrent varicocele. The examinations were performed with the patients prone, and a coronal imaging volume was used. The scrotal part of the varicocele was demonstrated in 3 cases and the spermatic vein in 2 cases. This technique could be an alternative to spermatic venography in the radiological mapping of dilated spermatic veins.

Acute spinal epidural abscess without concurrent spondylodiscitis. Successful closed treatment in 10 cases.

We performed a retrospective survey of the clinical records and radiological examinations of 10 patients with a diagnosis of spinal epidural abscess, without spondylodiscitis. All patients had an acute onset of fever and local or radiating back pain. 3 patients had mild, and 1 patient severe neurological symptoms. The diagnosis and subsequent regression of the abscess after treatment were verified by MRI. In all cases, the imaging findings included signs of septic arthritis in an adjoining facet joint. 7/10 abscesses were located in the lumbar region. Blood cultures showed Staphylococcus aureus as the etiological agent in 8/10 patients. In 2 cases, no agent was found, probably due to ongoing antibiotic therapy when the cultures were taken. All patients were treated successfully using antibiotics alone, with complete regression of the neurological symptoms.