[In-vivo assessment of multiple sclerosis pathology: the role of neuroimaging techniques].
Although the correlations between magnetic resonance imaging (MRI) findings and long-term disease evolution range from poor to moderate', conventional pre- and post-contrast MRI provides sensitive and reliable measures to monitor multiple sclerosis (MS) activity over time. The application of non-conventional techniques, such as magnetization transfer imaging (MTI), proton magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI), can increase the pathological specificity of MRI findings and, as a consequence, improve the relationship with the clinical evolution of the disease. These techniques also enable us to quantify the subtle abnormalities occurring in the so-called normal-appearing white matter, thus allowing to achieve a more accurate assessment of MS burden. Some of the aforementioned techniques have already shown their value for assessing MS dynamics, whereas other still need to go through a more complete validation process prior to any extensive clinical application in MS. The use of multiparametric MRI approaches, including both conventional techniques and new methods able to assess the macro- and microscopic disease burden and to characterize the individual lesion intrinsic nature, should improve our ability to study in vivo the pathology of MS.
Centro de Esclerosis Múltiple, Instituto Científico San Rafael, Milán, Italia. g.comi@hsr.it
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D001921:Brain / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis*