MRI in multiple sclerosis: clinical and research update.

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Clinical magnetic resonance imaging (MRI) is crucial for diagnosing multiple sclerosis (MS).
• However, standard MRI lacks specificity to fully investigate the complex pathogenic mechanisms of MS onset and progression.
• Advanced MR sequences are needed to characterize these mechanisms.

Purpose of the Study:

• To update on international guidelines for optimal standard MS imaging.
• To discuss the advantages and limitations of advanced imaging for investigating MS pathology.
• To provide an overview of methods for imaging specific pathological hallmarks of MS.

Main Methods:

• Review of recent international guidelines for multiple sclerosis imaging.
• Discussion of advanced magnetic resonance (MR) imaging techniques.
• Overview of methods for imaging inflammation, demyelination, and neurodegeneration.

Main Results:

• Advanced MR sequences enable characterization of diverse pathological mechanisms in MS.
• These techniques provide insights into MS natural history and treatment response.
• Specific methods exist for imaging leptomeningeal enhancement, microglial activation, demyelination, and neuronal damage.

Conclusions:

• Applying MR guidelines to standard protocols can optimize MS management.
• Mechanism-specific imaging techniques are powerful tools for elucidating MS pathogenesis.
• Advanced imaging aids in monitoring disease progression and guiding therapeutic choices.