The criteria was revised in 2005. I was diagnosed with PPMS in 2002 withcriteria matching except for the CSF (LP results) due to the 15% exceptions. The MRI is an excellent tool for MS, BUT it is only one tool. Location of lesions and the extent of the lesions is a factor. I am not a medical doctor; therefore, I would not want to mislead you. You should be tested using all the criteria.
The revised criteria from what I have read:
-For 2 or more attacks with objective clinical evidence of two or more lesions, no additional data are needed for MS diagnosis.
-For 2 or more attacks with objective clinical evidence of one lesion, additional criteria of dissemination in space may include either MRI or 2 or more MRI-detected lesions consistent with MS plus positive CSF findings or waiting for another clinical attack affecting a different clinical site.
-For 1 attack with objective clinical evidence of 2 or more lesions, additional data needed are dissemination in time demonstrated by MRI or second clinical attack.
-For 1 monosymptomatic attack with objective evidence of 1 lesion, additional data required are (1) dissemination in space with positive MRI result or 2 or more MRI-detected lesions consistent with MS plus positive CSF findings; and (2) dissemination in time demonstrated by MRI or second clinical attack.
-For insidious neurologic progression suggestive of MS, additional data needed for diagnosis are 1 year of disease progression and 2 of the following: (1) positive brain MRI findings, (2) positive spinal cord MRI findings, and (3) positive CSF findings.
MRI criteria are as follows:
-The revisions now allow for either contrast-enhancing brain lesions or T2 lesions occurring in the first few weeks after the onset of a first clinical episode to be part of the criterion of dissemination in time.
-T2 lesions occurring within a few weeks of a first attack should not be considered a separate event for the criterion of dissemination in time.
* Any new T2 lesion occurring after the reference scan performed at least 30 days after the onset of the initial clinical event may be useful in meeting diagnostic criteria.
- A new T2 lesion must be sufficient in size and location to reflect one that could not have been previously missed for technical reasons.
-Spinal cord lesions detected by T2 may be helpful in diagnosis if brain imaging does not detect dissemination in space in a patient with suspected MS.
-Spinal cord lesions should be focal.
-For dissemination in space, a spinal cord lesion is equivalent to and can substitute for a brain infratentorial lesion but not for a periventricular or juxtacortical lesion.
-An enhancing spinal cord lesion is equivalent to an enhancing brain lesion.
-Individual spinal cord lesions can contribute together with individual brain lesions to reach the diagnosis of PPMS.
-Repeat spinal cord imaging in the absence of clinical symptomatic myelitis has low yield and should not be performed unless there is clinical evidence of a new spinal cord lesion.
Diagnosis of PPMS
-The 2005 criteria for PPMS are simplified.
-A positive CSF finding is no longer a requirement for the diagnosis of PPMS.
-The criteria now include 1 year of disease progression plus 2 of the following: (1) positive brain MRI results (9 T2 lesions or 4 or more T2 lesions with visual evoked potential), (2) positive spinal cord MRI result (2 focal T2 lesions), and (3) positive CSF findings.
I hope this helps!