Magnetic resonance imaging in multiple sclerosis. A review

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Multiple sclerosis (MS) diagnosis relies heavily on clinical suspicion.
• Established diagnostic tools include cerebrospinal fluid examination and evoked potentials.
• Magnetic resonance imaging (MRI) emerged as a key paraclinical investigation in 1981.

Purpose of the Study:

• To highlight the significance of MRI in diagnosing multiple sclerosis (MS).
• To discuss the insights gained from follow-up MRI studies in understanding MS dynamics.
• To evaluate the impact of subclinical disease activity on MS understanding and therapeutic monitoring.

Main Methods:

• Utilizing magnetic resonance imaging (MRI) for diagnosis and follow-up in multiple sclerosis (MS) patients.
• Employing MRI with and without paramagnetic contrast enhancement.
• Reviewing European Community (EC) guidelines for MRI use in MS-related studies.

Main Results:

• MRI sensitivity exceeds that of cerebrospinal fluid examination and trimodal evoked potentials for MS diagnosis.
• Follow-up MRI studies reveal 'realtime' disease dynamics, including subclinical activity, not always apparent clinically.
• Paramagnetic contrast enhancement aids in understanding disease activity and progression.

Conclusions:

• Clinical suspicion remains essential for accurate MRI interpretation in MS.
• MRI provides critical insights into the dynamic nature of multiple sclerosis.
• Standardized MRI guidelines (e.g., EC guidelines) are vital for optimizing multicenter research and therapeutic trials in MS.