Neuroimaging clinics of North America
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Increased iron deposition in cerebral deep gray matter has been considered a global marker for neurodegeneration in multiple sclerosis (MS); it scales with disease duration and severity. Iron accumulation in white matter and MS lesions might be more directly related to disease activity and has been discussed as a contributor to the inflammatory and neurodegenerative cascade. ⋯ We discuss findings from MR iron mapping proposed. Because of the confounding magnetic properties of myelin, iron mapping in white matter remains an unresolved issue.
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Multiple sclerosis is a multifactorial disease with heterogeneous pathogenetic mechanisms, which deserve to be studied to evaluate new possible targets for treatments and improve patient management. MR spectroscopy and PET allow assessing in vivo the molecular and metabolic mechanisms underlying the pathogenesis of multiple sclerosis. This article focuses on the relationship between these imaging techniques and the biologic and chemical pathways leading to multiple sclerosis pathology and its clinical features. Future directions of research are also presented.
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Neuroimaging Clin. N. Am. · May 2017
ReviewInsights from Ultrahigh Field Imaging in Multiple Sclerosis.
Ultrahigh-field (≥7 T) magnetic resonance (MR) imaging is being used at many leading academic medical centers to study neurologic disorders. The improved spatial resolution and anatomic detail are due to the increase in signal-to-noise and contrast-to-noise ratio at higher magnetic field strengths. Ultrahigh-field MR imaging improves multiple sclerosis (MS) lesion detection, with particular sensitivity to detect cortical lesions. The increase in magnetic susceptibility effects inherent to ultrahigh field can be used to detect pathologic features of MS lesions, including a central vein, potentially useful for diagnostic considerations, and heterogeneity among MS lesions, potentially useful in determining lesion outcomes.
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Neuroimaging Clin. N. Am. · May 2017
ReviewRadiologically Isolated Syndrome: MR Imaging Features Suggestive of Multiple Sclerosis Prior to First Symptom Onset.
Remarkable advances in the understanding of the biology of multiple sclerosis have been achieved through the use of conventional and novel MR imaging techniques of the central nervous system. With improvements in access by patients and utilization of MR imaging technology in health care, an increasing number of unanticipated structural anomalies are being appreciated. In certain instances, white matter abnormalities within the brain and spinal cord are discovered in subjects with no prior history of neurologic symptoms supportive of inflammatory demyelinating events.
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Neuroimaging Clin. N. Am. · May 2017
ReviewBrain and Spinal Cord MR Imaging Features in Multiple Sclerosis and Variants.
Multiple sclerosis (MS) is a disabling disease, with the first symptoms mostly appearing early in life. In addition to the clinical and laboratory findings, imaging has become increasingly important for diagnosis, prognosis, and monitoring. Because of its importance for these purposes, a high level of knowledge of imaging MS pathology and a standardization of the imaging acquisition, interpretation, and reporting is necessary. Here we will describe the MR imaging characteristics of MS pathology, the current imaging protocols, diagnostic criteria, and the differential diagnosis of MS.