Chapter 5 - Advances in Multiple Sclerosis Imaging

Abstract

Magnetic resonance imaging (MRI) is an important tool in the diagnosis and management of several neurologic conditions. This chapter discusses the significance of the widely available standard MRI techniques and reviews advanced MRI methods that are currently utilized primar­ily in research studies, some of which may become important in everyday clinical practice in the near future. MRI findings constitute an important cornerstone in the diagnostic criteria findings in two important idiopathic inflammatory demyelinating diseases––neuromyelitis optica (NMO) and acute disseminated encephalomyelitis (ADEM). A new imaging modality, optical coherence tomography (OCT), and its role in multiple sclerosis (MS) research and future clinical trials are described. Two MRI criteria followed in the diagnosis of MS are criteria for dissemination in space and time. The techniques that acts as important tools in MS research and are being applied in routine clinical practice are (1) magnetization transfer imaging (MTI), (2) diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI), (3) perfusion-weighted imaging, (4) T1 and T2 relaxometry, (5) magnetic resonance spectroscopy, and (6) phosphorus magnetic resonance spectroscopy (MRS). In MS research, these techniques have helped clarify several previously poor­ly understood features of this complex disease. OCT is expected to play an important part in assessing axonal and neuronal damage in all forms of MS and it may be a useful outcome measure in clinical trials addressing repair and neuroprotection.