State-of-the-art neuroimaging techniques in pathogenesis of multiple sclerosis

Abstract

Magnetic resonance imaging (MRI) is one of the main methodsof multiple sclerosis (MS) diagnostic, differential diagnostic anddisease course monitoring. Conventional MRI techniques havelow sensitivity in the assessment of diffuse damage of normalappearing white matter and focal/diffuse damage of grey matterwhich are of great interest in MS. Advanced MRI techniquesallow to get over these limitations and to obtain more specificinformation about MS pathogenesis. Thus MR-spectroscopymetabolites analysis helps to assess inflammation, myelin structure,remyelination and axonal loss or dysfunction, i.e. lets ussee pathochemical changes in MS. Demyelination and axonalloss differentiation is possible due to MR magnetization transfertechnique and also diffusion tensor imaging, which characterizewater diffusion in the brain tissue restricted by cell membranesand axonal cytoskeleton. Grey matter damage could be assessedusing sequences with one or two inverted impulses and morphometricanalysis of atrophy. Functional MRI performance usingdifferent paradigms characterizes cortical reorganization inresponse to functional injury. Vascular aspects of MS are alsowidely discussed nowadays. MR-perfusion and susceptibilityweighted imaging allow assessing perfusion and venous flowingchanges. State-of-the art neuroimaging methods let us performdetailed analysis of tissue damage in MS including the cell level,obtain more precise information about functional, metabolicand pathologic features, therapy influence on the inflammatoryreactions and neuroprotection. Perspective use of high-field MRscanners (more than 1.5 T) will lead to the increase of sensitivityof different pathologic mechanisms detection.

Keywords

• multiple sclerosis
• magnetic resonance imaging
• pathogenesis