[Magnetic resonance in the diagnosis and treatment of multiple sclerosis].
Although the diagnosis of multiple sclerosis is still based on clinical criteria, confirmation by magnetic resonance imaging (MRI) is considered to be essential, thank to its high sensitivity in demonstrating the spatial dissemination of the demyelinating plaques in the brain and spinal cord. Additionally, MRI can establish an approximation of the pathological substrate of the multiple sclerosis plaques and it has proven useful for studying the natural history of the disease and monitoring the effects of new treatments. This capacity of MRI is based on its ability to estimate the degree of demyelination, gliosis, edema, inflammation and axonal damage and to detect diffuse involvement of the normal appearing white matter. The selective identification of the lesions that contribute most to the patient's disability and clinical progression, such as severe demyelination and axonal damage, improves the MRI correlation with the neurological impairment scales. However, a correct application of MRI in the study of multiple sclerosis requires standardization of the techniques and sequences used in the different clinical forms of the disease and of the systems for measuring the lesion load. In this way multiple sclerosis can serve as a true biological marker of the severity of the disease.
Rovira Cañellas
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Departamento de Radiología, Hospitals Vall d'Hebron, Barcelona. arovira@hg.vhebron.es
D001284:Atrophy; D001921:Brain / Q000473:pathology*; D001929:Brain Edema / Q000209:etiology / Q000473:pathology; D002986:Clinical Trials as Topic / Q000379:methods; D003287:Contrast Media; D003711:Demyelinating Diseases; D003937:Diagnosis, Differential; D005911:Gliosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000473:pathology
D003287:Contrast Media