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Imaging Studies IV: Magnetic Resonance Imaging

Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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A three-year, multi-parametric MRI study in patients at presentation with CIS.

Maria A Rocca1, Federica Agosta, Maria P Sormani

  • 1Neuroimaging Research Unit, Dept. of Neurology, Scientific Institute and University Ospedale, San Raffaele, Via Olgettina, 60, 20132 Milan, Italy.

Journal of Neurology
|February 16, 2008
PubMed
Summary

Clinically isolated syndromes (CIS) patients who show MRI evidence of disease dissemination in space are at higher risk of developing definite multiple sclerosis (MS). Macroscopic lesions, not diffuse damage, predict MS conversion in early stages.

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Published on: February 19, 2021

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Clinically isolated syndromes (CIS) represent the earliest clinical presentation suggestive of multiple sclerosis (MS).
  • Understanding early brain damage and predictors of conversion to definite MS is crucial for timely intervention.
  • Non-conventional magnetic resonance (MR) metrics may offer insights into subclinical disease processes.

Purpose of the Study:

  • To quantify overall brain damage in CIS patients.
  • To identify non-conventional MR metrics that predict conversion to definite MS.
  • To evaluate the role of magnetization transfer (MT) parameters in early MS.

Main Methods:

  • Conventional and MT MRI scans were acquired from 208 CIS patients and 55 controls.
  • Measures included T2, T1, and gadolinium-enhancing lesion volumes, normalized brain volume (NBV), and MTR histogram metrics for normal-appearing white matter (NAWM) and grey matter (GM).
  • Patients were followed for a median of 3.1 years to assess conversion to definite MS.

Main Results:

  • 43% of CIS patients converted to definite MS during follow-up.
  • Significant inter-center heterogeneity was observed for lesion volumes, NBV, and MTR metrics at baseline.
  • MRI criteria for dissemination in space (DIS), but not NBV or MTR metrics, independently predicted conversion to definite MS.

Conclusions:

  • Irreversible brain tissue injury is present in early CIS.
  • Macroscopic focal lesions, specifically fulfilling MRI criteria for DIS, are associated with an increased risk of developing definite MS.
  • "Diffuse" brain damage measured by MTR did not predict conversion in this cohort.