Massimo Filippi1, Paolo Preziosa, Maria A Rocca. 1. Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Abstract
PURPOSE OF REVIEW: To summarize recent findings from the application of MRI in the diagnostic work-up of patients with suspected multiple sclerosis (MS), and to review the insights into disease pathophysiology and the utility of MRI for monitoring treatment response. RECENT FINDINGS: New evidence from the application of MRI in patients with clinically isolated syndromes has guided the 2017 revision of the McDonald criteria for MS diagnosis, which has simplified their clinical use while preserving accuracy. Other MRI measures (e.g., cortical lesions and central vein signs) may improve diagnostic specificity, but their assessment still needs to be standardized, and their reliability confirmed. Novel MRI techniques are providing fundamental insights into the pathological substrates of the disease and are helping to give a better understanding of its clinical manifestations. Combined clinical-MRI measures of disease activity and progression, together with the use of clinically relevant MRI measures (e.g., brain atrophy) might improve treatment monitoring, but these are still not ready for the clinical setting. SUMMARY: Advances in MRI technology are improving the diagnostic work-up and monitoring of MS, even in the earliest phases of the disease, and are providing MRI measures that are more specific and sensitive to disease pathological substrates.
PURPOSE OF REVIEW: To summarize recent findings from the application of MRI in the diagnostic work-up of patients with suspected multiple sclerosis (MS), and to review the insights into disease pathophysiology and the utility of MRI for monitoring treatment response. RECENT FINDINGS: New evidence from the application of MRI in patients with clinically isolated syndromes has guided the 2017 revision of the McDonald criteria for MS diagnosis, which has simplified their clinical use while preserving accuracy. Other MRI measures (e.g., cortical lesions and central vein signs) may improve diagnostic specificity, but their assessment still needs to be standardized, and their reliability confirmed. Novel MRI techniques are providing fundamental insights into the pathological substrates of the disease and are helping to give a better understanding of its clinical manifestations. Combined clinical-MRI measures of disease activity and progression, together with the use of clinically relevant MRI measures (e.g., brain atrophy) might improve treatment monitoring, but these are still not ready for the clinical setting. SUMMARY: Advances in MRI technology are improving the diagnostic work-up and monitoring of MS, even in the earliest phases of the disease, and are providing MRI measures that are more specific and sensitive to disease pathological substrates.
Authors: Shiva Shahrampour; Justin Heholt; Andrew Wang; Faezeh Vedaei; Feroze B Mohamed; Mahdi Alizadeh; Ze Wang; George Zabrecky; Nancy Wintering; Anthony J Bazzan; Thomas P Leist; Daniel A Monti; Andrew B Newberg Journal: Heliyon Date: 2021-07-16
Authors: Margarete M Voortman; Anna Damulina; Lukas Pirpamer; Daniela Pinter; Alexander Pichler; Christian Enzinger; Stefan Ropele; Gerhard Bachmaier; Juan-Jose Archelos; Gunther Marsche; Michael Khalil Journal: Biomolecules Date: 2021-08-25
Authors: Hugo Vrenken; Mark Jenkinson; Dzung L Pham; Charles R G Guttmann; Deborah Pareto; Michel Paardekooper; Alexandra de Sitter; Maria A Rocca; Viktor Wottschel; M Jorge Cardoso; Frederik Barkhof Journal: Neurology Date: 2021-10-04 Impact factor: 9.910