TO EVALUATE THE ROLE OF MRI IN DETECTING AND MONITORING SPINAL CORD LESIONS IN PATIENTS DIAGNOSED WITH MULTIPLE SCLEROSIS

Abstract

Background: Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system, where spinal cord involvement is both diagnostically and prognostically significant. MRI plays a vital role in visualizing demyelinating lesions and assessing disease progression. Objective: To evaluate the role of MRI in detecting and monitoring spinal cord lesions in patients diagnosed with multiple sclerosis. Methodology: This cross-sectional study was conducted over three months at Shaikh Zayed Medical College and various tertiary care hospitals in Punjab. A total of 102 clinically confirmed MS patients aged 18–80 years, who had undergone spinal MRIs, were included using a non-probability purposive sampling technique. Patients with tumors, trauma, or contraindications to MRI were excluded. Results: Among 102 MS patients, ataxia (34.3%) was the most prevalent primary symptom, followed by optic neuritis (26.5%) and leg weakness (21.6%). Most patients (52.0%) were above 50 years of age, with a nearly equal gender distribution (51.0% female, 49.0% male). MRI revealed cervical lesions in 72.5%, thoracic lesions in 81.4%, and lumbar lesions in 39.2%. Regarding disability, 30.4% had moderate, 24.5% mild, 15.7% severe, and 29.4% had no bility. Lesion activity indicated 33.3% stable, 24.5% mixed, 23.5% chronic, and 18.6% active lesions. Diagnostically, 30.4% were SPMS, 25.5% PPMS, 12.7% RRMS, and 31.4% fell into other subtypes. Cervical and thoracic lesions were consistently observed across age groups, with thoracic involvement being universal (100%) among younger patients aged 20–35 years. Conclusion: MRI is a highly effective tool for detecting and monitoring spinal cord lesions in MS, revealing significant lesion burden even in early and less symptomatic stages. The high prevalence of cervical and thoracic lesions across all age groups, particularly among younger patients, underscores MRI’s utility in timely diagnosis and disease stratification. These findings reinforce MRI's role as a cornerstone in MS management and prognosis assessment.