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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Magnetic resonance techniques in multiple sclerosis: the present and the future
Massimo Filippi1, Maria A Rocca, Nicola De Stefano
1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Via Olgettina, 60, 20132 Milan, Italy. m.filippi@hsr.it
Abstract:
Magnetic resonance imaging (MRI) is sensitive to focal multiple sclerosis (MS) lesions. For this reason, conventional MRI measures of the burden of disease derived from dual-echo, fluid-attenuated inversion recovery and postcontrast T1-weighted sequences are regularly used to monitor disease course in patients with confirmed MS and have been included in the diagnostic workup of patients in whom MS is suspected. Other quantitative magnetic resonance (MR)-based techniques with a higher pathological specificity (including magnetization transfer-MRI, diffusion tensor-MRI, and proton MR spectroscopy) have been extensively applied to measure disease burden within focal visible lesions and in the normal-appearing white matter and gray matter of MS patients at different stages of the disease. These methods, combined with functional imaging techniques, are progressively improving our understanding of the factors associated with MS evolution. More recently, the application of new imaging modalities capable of measuring pathological processes related to the disease that have been neglected in the past (eg, iron deposition and perfusion abnormalities) and the advent of high- and ultrahigh-field magnets have provided further insight into the pathobiological features of MS. After a brief summary of the main results obtained from the established and emerging MR methods, this review discusses the steps needed before the latter become suitable for widespread use in the MS research community.
Insights
Magnetic resonance imaging (MRI) offers insights into multiple sclerosis (MS) lesions. Advanced MRI techniques enhance understanding of MS progression and pathology, paving the way for broader research applications.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple sclerosis (MS) diagnosis and monitoring rely on conventional magnetic resonance imaging (MRI) for lesion detection.
- Established MRI sequences like dual-echo, FLAIR, and postcontrast T1-weighted are standard for assessing disease burden.
- Advanced quantitative MRI techniques offer higher pathological specificity for MS.
Purpose of the Study:
- To review established and emerging MRI methods for assessing MS disease burden.
- To explore novel imaging modalities and high-field magnets for deeper insights into MS pathobiology.
- To discuss the requirements for integrating advanced MRI techniques into MS research.
Main Methods:
- Conventional MRI sequences (dual-echo, FLAIR, postcontrast T1-weighted).
- Quantitative MRI techniques: Magnetization Transfer (MT-MRI), Diffusion Tensor MRI (DT-MRI), Proton MR Spectroscopy (MRS).
- Emerging modalities assessing iron deposition and perfusion, utilizing high- and ultrahigh-field magnets.
Main Results:
- Conventional MRI effectively detects focal MS lesions and monitors disease course.
- Quantitative MRI methods provide detailed insights into lesion and normal-appearing tissue pathology.
- Newer techniques and advanced magnets are revealing previously neglected pathological features of MS.
Conclusions:
- Established MRI techniques are crucial for routine MS management.
- Emerging MRI methods hold significant potential for advancing MS research and understanding.
- Further validation is needed before widespread adoption of advanced MRI techniques in the MS research community.
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