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Updated: Jun 18, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Examination of the role of MRI in multiple sclerosis: a problem orientated approach
1Neuroimmunology Branch, NINDS, NIH, Bethesda, MD, USA. mcfarlandh@ninds.nih.gov
Abstract:
Current multiple sclerosis (MS) is generally thought to consist of two general pathological processes; acute inflammation and degeneration. The relationship between these two components is not understood. What is clear, however, is that the measures of acute inflammation are a poor predictor of long-term disability. Although some have suggested that inflammation may not contribute directly to the essential pathology in MS or that it is secondary to tissue degeneration, most students of the disease believe that the two processes are linked. Therefore, applications of MRI to measure both components of the disease are important. As most readers know, considerable success has been achieved in measuring acute inflammation and very little success has been obtained in identifying measures that correlate with disability and the prediction of future disability has not been achieved. In this review, we will examine the successes and failures of MRI in measuring these two components of the disease process. Consequently, we will not attempt to provide a detailed review of each MRI technique or sequence that has been applied to MS (a number of excellent reviews are available) but rather discuss how these techniques have been applied to answer specific questions. We will provide some comments on the use of MRI in clinical trials as well as in clinical practice. Finally, we will end with a brief discussion of future challenges.
Insights
Magnetic resonance imaging (MRI) shows success in measuring acute inflammation in multiple sclerosis (MS) but struggles to predict long-term disability. Further research is needed to link inflammation and degeneration for better MS outcome prediction.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Multiple sclerosis (MS) pathology involves acute inflammation and degeneration, with their relationship unclear.
- Current acute inflammation measures poorly predict long-term MS disability.
- The role of inflammation in MS pathogenesis, whether primary or secondary to degeneration, is debated.
Purpose of the Study:
- To review the successes and failures of MRI in measuring both inflammatory and degenerative components of MS.
- To discuss the application of MRI techniques in answering specific questions about MS pathology.
- To comment on the utility of MRI in clinical trials and practice for MS.
Main Methods:
- Review of existing literature on MRI applications in multiple sclerosis.
- Focus on how MRI techniques have been used to assess disease components.
- Discussion of MRI's role in clinical settings and research.
Main Results:
- Significant success in using MRI to measure acute inflammation in MS.
- Limited success in identifying MRI measures that correlate with disability or predict future MS progression.
- Challenges remain in accurately assessing the degenerative aspect of MS via MRI.
Conclusions:
- MRI is effective for tracking acute MS inflammation but less so for predicting long-term disability.
- Bridging the gap between measuring inflammation and degeneration with MRI is crucial for MS management.
- Future MRI advancements are needed to improve prediction of MS disability and guide clinical decisions.
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