Advances in spinal cord imaging in multiple sclerosis.

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Multiple sclerosis (MS) frequently impacts the spinal cord, leading to significant neurological deficits.
• Pathological changes like demyelination and neuroaxonal loss in the MS spinal cord are typically studied using magnetic resonance imaging (MRI).

Purpose of the Study:

• To review and discuss recent advancements in spinal cord MRI techniques for multiple sclerosis.
• To highlight the utility of spinal cord MRI in lesion identification, prognosis prediction, and disease monitoring.

Main Methods:

• Review of recent literature on conventional and advanced spinal cord MRI techniques.
• Discussion of novel post-processing methods for lesion identification and atrophy quantification.
• Exploration of quantitative imaging techniques for assessing neuroaxonal integrity and myelin content.

Main Results:

• Improved identification and characterization of MS spinal cord lesions, aiding differentiation from other myelopathies.
• Spinal cord atrophy, occurring at a higher rate than brain atrophy, shows potential as a crucial outcome measure in MS clinical trials.
• Advances in automated analysis and quantitative imaging provide deeper insights into MS pathophysiology.

Conclusions:

• Spinal cord MRI is rapidly evolving, offering enhanced diagnostic and prognostic capabilities for multiple sclerosis.
• Spinal cord atrophy quantification is becoming increasingly feasible and valuable for clinical trial design.
• Future research, including the impact of ultra-high field MRI (7T), promises further breakthroughs in understanding MS spinal cord pathology.