Computerized axial tomography and diagnosis of multiple sclerosis

Paulo R.M. Bittencourt, Brian E. Kendall

Computed axial tomography (C.T.) findings are illustrated in 3 patients who presented with C.T. changes suggesting respectively chronic M.S., acute M.S., and an appearance simulating a malignant tumour. Review of the literature shows that the chronic form with cerebral atrophy and low density lesions in the hemispheres is common in patients with a long history and is unlikely to cause diagnostic difficulty. The acute presentation is less common and could be confused with a variety of causes of multiple low density enhancing lesions. The C.T. diagnosis of M.S. is more difficult in rare cases in which plaques cause mass effect and show ring enhancement; all 3 such cases in the literature were subjected to cerebral biopsy.