MRI-clinical correlations: more than inflammation alone-what can MRI contribute to improve the understanding of pathological processes in MS?

Area of Science:

• Neuroimaging
• Neuropathology
• Multiple Sclerosis Research

Background:

• Magnetic resonance imaging (MRI) is crucial for detecting and monitoring multiple sclerosis (MS) lesions.
• The histopathologic basis of MRI-detected changes in MS remains incompletely understood.
• Current MRI techniques may not reflect specific histopathologic changes but rather a spectrum of tissue alterations.

Purpose of the Study:

• To review current MRI-pathology correlations in multiple sclerosis (MS).
• To elucidate the evolution of pathologic changes in MS lesions and non-lesional white matter as visualized by MRI.
• To discuss the potential future role of advanced MRI in understanding MS dynamics.

Main Methods:

• Literature review of studies correlating MRI findings with histopathologic data in MS.
• Analysis of existing research on the temporal evolution of MS lesions and white matter changes.
• Discussion of emerging MRI techniques and their potential for in-vivo pathology assessment.

Main Results:

• MRI detects various pathological changes in MS, not always specific to histopathology.
• Understanding lesion evolution requires integrating imaging and pathological data.
• Non-lesional white matter also exhibits pathological changes detectable by MRI.

Conclusions:

• MRI-pathology correlation is essential for interpreting MS imaging findings.
• Further research is needed to refine MRI's ability to reflect specific MS pathologies.
• Advanced MRI techniques hold promise for revealing the dynamic nature of MS pathology.