La esclerosis múltiple, la resonancia magnética y los nuevos criterios McDonald 2024

Introduction: Neurodegenerative diseases, such as multiple sclerosis, represent a challenge for modern medicine. Along with clinical and laboratory criteria, magnetic resonance imaging (MRI) is the gold standard for visualizing demyelinating lesions, detecting alterations in the brain and the spinal cord in patients without obvious clinical symptoms. Objective: To identify and analyze relevant aspects of MRI in the diagnosis of patients with multiple sclerosis, based on a review of the national and international literature and evidence that supports or refutes the success of the most assertive criteria for diagnosis. Material and Methods: More than 150 articles published between 2020 and 2025 were reviewed using keywords in PubMed/MEDLINE, SciELO, The National Library of Medicine, and Google Scholar. Those referring to multiple sclerosis, MRI, and the McDonald criteria for diagnosing the disease were selected. Results: The epidemiology of this disease is changing rapidly. There has been an increase in its incidence due to improved diagnosis, since the introduction of magnetic resonance imaging and from prevalence to increased survival. The McDonald 2024 diagnostic criteria consider additional characteristics that allow for diagnosis at an earlier stage of the disease, even without clinical symptoms. Conclusions: Magnetic resonance imaging is important in the diagnosis, monitoring, prognosis, and investigation of multiple sclerosis, a chronic, inflammatory, and neurodegenerative disease of the brain and spinal cord. The McDonald 2024 criteria point to a reasonable clinical suspicion, along with supportive magnetic resonance imaging and paraclinical evidence.