Current opinion in neurology
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Conventional magnetic resonance imaging (MRI) techniques acquire signal mainly from differences in relaxation properties and density of free water protons. Thus, the sensitivity in depicting lesions is high but pathological specificity is poor. Efforts are being made to increase the diagnostic power of MRI; better correlation with the clinical presentation and the use of better MRI criteria have increased the specificity of the conventional T2 sequences. ⋯ The basic aspects of the pathological lesions in multiple sclerosis such as oedema, membrane disruption, demyelination, gliosis, cellular infiltration and axonal loss, can be studied more precisely by the new magnetic resonance techniques, which should better describe the actual clinical impact of the destructive process. In the past year the importance of axonal loss has simultaneously been confirmed by magnetic resonance spectroscopy and pathological findings. However, magnetization transfer imaging, magnetic resonance diffusion imaging and functional MRI are under intensive investigation for a better analysis of these different factors that impact on the reversibility of the patients disability.