REVIEW   

Journal of Radiological Review 2021 September;8(3):218-29

DOI: 10.23736/S2723-9284.21.00116-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Imaging findings and diagnosis of atypical aggressive demyelinating lesions of the central nervous system

Matteo PAOLETTI ¹ ✉, Shaun I. MUZIC ², Francesca MARCHETTI ², Carlo ASTEGGIANO ^{1, 3}, Anna PICHIECCHIO ^{1, 3}, Stefano BASTIANELLO ^{1, 3}

¹ Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy; ² University of Pavia, Pavia, Italy; ³ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

In the last decades, some atypical demyelinating diseases of the central nervous system have been better described and differentiated from classical phenotypes of multiple sclerosis. These conditions have been more precisely defined over time based on clinico-radiological and laboratory criteria, such as in the case of neuromyelitis optica. However, other entities still remain not fully understood, even though they have been known and studied for a long time. Additionally, the etiology of other recently described rare entities, such as solitary sclerosis or diffuse confluent or cavitary demyelinating lesions, has not yet been adequately clarified. In all these cases, the differential diagnosis remains difficult even with the use of advanced MRI techniques. A broad spectrum of knowledge of such conditions, as well as their main differential diagnoses, is essential to guide the diagnosis.

KEY WORDS: Demyelinating factors; Brain; Multiple sclerosis