Magnetic Resonance Imaging of Central Nervous System and Paranasal Sinuses in Multiple Sclerosis Patients: Findings from a Survey of Clinical Records in Kermanshah Province

Background and Objectives: Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system with more than 5.2 million people across the world being afflicted with. Magnetic Resonance Im‌aging (MRI) is a valuable tool in the diagnosis of MS. This study surveys the results of MRI of the central nervous system and paranasal sinuses in the sample of MS patients in Kermanshah Province, Iran.   Methods: The clinical records of a total of 294 patients admitted to the Neurology Ward of Farabi Hospital of Ker‌manshah City (Western Iran) between 2004 and 2014 and diagnosed to be afflicted with MS were surveyed. The data were collected using a checklist prepared based on the McDonald Wibers standard criteria. The checklist consisted of 37 items, related to the MRI data of the CNS and paranasal sinuses of MS patients. The data were collected in four domains, including the most common early clinical signs of the patient, distribution of lesions, affliction with sinusitis, and demographic characteristics. The collected data were summarized using descriptive statistical methods.   Findings: MRI identified MS plaques in 94.90% of the patients. Female, Married, housekeeping, and under‌graduate patients and the patients with 21-40 years of age had the highest frequency among the MS patients (59.5%, 50.2%, 70.6%, 42%, and 72%). Hands and feet anaesthesis was the most frequently seen early signs (63.80%), followed by visual impairment (42.3%) and ataxia (12.6%). The most frequently involved anatomic site was the white matter surrounding the ventricles (77.50%), followed by centrum semiovale (75.4%), and corpus callosum (17.1%). We also found that 16% of the patients afflicted with MS had sinusitis, with the most frequent anatomical sites afflicted in them being sphenoid sinuses (63.8%).   Conclusions: Our study provided further evidence that the MRI is an accurate and reliable method for diag‌nosing MS. No gross differences in the frequency of MS disease among age, sex, and lesion pattern groups compared to other studies were identified. Observing sinusitis in patients afflicted with MS is suggestive of their random association.