European Journal of Cardiovascular Medicine

Magnetic Resonance Imaging (MRI) has revolutionized the field of neuroimaging, providing unparalleled detail and clarity in the visualization of brain structures. This non-invasive technique employs powerful magnetic fields and radio waves to generate precise images of the nervous system, enabling early and accurate diagnosis of various neurological disorders. Despite its widespread use, the efficacy of MRI in diagnosing specific conditions such as multiple sclerosis [1][5], stroke, brain tumors, and neurodegenerative diseases remains a topic of ongoing research. This study aims to critically evaluate the diagnostic accuracy and clinical utility of MRI across a spectrum of neurological disorders, comparing its effectiveness with other imaging modalities. By analyzing recent advancements and clinical outcomes, this research seeks to provide a comprehensive assessment of MRI's role in enhancing diagnostic precision and improving patient management in neurology.

Study Design: Prospective cohort study conducted from January 2023 to December 2023 at Gayatri Vidya Parishad Institute of Health Care and Medical Technology, with IRB approval and informed consent.

Participants: 200 patients (aged 18-75) with suspected neurological disorders (MS, AD, PD, epilepsy) were included. Exclusion criteria: MRI contraindications, previous neurological surgery, known MRI-detectable brain lesions.

Imaging Procedure: MRI scans were performed using a 3 Tesla scanner. Standardized protocols included T1, T2, FLAIR, and DWI sequences, with specific sequences for each disorder.

Diagnostic Criteria: Diagnoses confirmed using established criteria:

• MS: McDonald criteria
• AD: NIA-AA criteria
• PD: UK Parkinson's Disease Society Brain Bank criteria
• Epilepsy: ILAE criteria

Data Collection: Blinded radiologists reviewed MRI scans. Data on lesion characteristics, location, and severity were recorded. Clinical diagnoses confirmed by neurologists.

Outcome Measures: Primary outcome: diagnostic accuracy (sensitivity, specificity, PPV, NPV) of MRI for each disorder. Secondary outcome: inter-observer agreement (Cohen’s kappa).

Statistical Analysis: Sensitivity, specificity, PPV, and NPV calculated. Inter-observer agreement assessed using Cohen’s kappa. Statistical significance set at p < 0.05.

Participant Demographics: The study included 200 patients (mean age 56.2 ± 12.4 years; 110 males, 90 females). The cohort comprised 60 patients with multiple sclerosis (MS), 50 with Alzheimer’s disease (AD), 40 with Parkinson’s disease (PD), and 50 with epilepsy.

Diagnostic Accuracy and Lesion Characteristics

The diagnostic performance of MRI and common lesion characteristics for each neurological disorder are summarized in Table 1.

Table 1. Diagnostic Accuracy and Lesion Characteristics of MRI

Inter-observer Agreement

Cohen’s kappa coefficients indicated high inter-observer agreement: MS (0.92), AD (0.85), PD (0.80), and epilepsy (0.87).

Summary: MRI demonstrated high diagnostic accuracy and reliability for MS, AD, PD, and epilepsy, confirming its efficacy as a diagnostic tool for neurological disorders

This study highlights the efficacy of MRI in diagnosing multiple sclerosis (MS), Alzheimer’s disease (AD), Parkinson’s disease (PD), and epilepsy [4], demonstrating high sensitivity and specificity across these conditions. MRI reliably detected characteristic lesions such as periventricular and juxtacortical lesions in MS, hippocampal and medial temporal lobe atrophy in AD, decreased signal in the substantia nigra in PD, and mesial temporal sclerosis in epilepsy. The high inter-observer agreement further underscores MRI's consistency and reliability in clinical practice, supporting its role as a primary diagnostic tool.

Despite the study's promising results, limitations include its single-center design and the exclusion of advanced imaging techniques. Future research should validate these findings in diverse populations and explore the integration of functional MRI and other modalities to potentially enhance diagnostic precision. Overall, MRI proves to be a crucial and reliable tool for diagnosing and managing various neurological disorders

This study confirms the high diagnostic accuracy and reliability of MRI in diagnosing multiple sclerosis, Alzheimer’s disease, Parkinson’s disease [3][7], and epilepsy. With significant sensitivity and specificity, MRI effectively identifies characteristic lesions associated with these disorders, supporting its role as an essential tool in clinical neurology. High inter-observer agreement further emphasizes the consistency of MRI interpretations. Despite the study's single-center limitation, the findings underscore MRI’s critical role in enhancing diagnostic precision and patient management in neurology. Future research should explore advanced imaging techniques and broader populations to validate these results.

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