The Role of Magnetic Resonance Imaging in The Diagnosis of Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic autoimmune disease where the immune system wrongly attacks the central nervous and is characterized pathologically by demyelination and clinically by visual, sensory, and motor problems. This immune-mediated disease is one of the most common causes of neurological disability in young adults worldwide and currently is increasing in prevalence and incidence globally. Early and accurate diagnosis is of the utmost importance. Blood test, Spinal tap using lumbar puncture, Neurological exam and Magnetic Resonance imaging are the 4 common diagnostic tools for MS provident. MRI techniques are able to reveal a range of pathological substrates of MS lesions that include edema, inflammation, demyelination, and axonal loss. As well as being a diagnostic tool, serial MRI scanning can be useful as an objective measure to monitor lesion activity, lesion load, and response to treatment with disease modify.
The problem of identifying lesions in the periventricular region, which is a common site for MS lesions, can also be addressed by suppressing the signal from CSF yet maintaining heavy T2 weighting using a fluid attenuated inversion recovery (FLAIR) sequence. This sequence is also superior at detecting cortical/juxtacortical lesions.
A host of MRI techniques, which are able to monitor disease evolution, have been introduced for the assessment of MS. T1-W, T2- WI, PD-W, Fluid-attenuated inversion recovery (FLAIR), Magnetization Transfer Imaging (MTI), Susceptibility weighted imaging (SWI), Double inversion recovery (DIR), Diffusion-weighted imaging (DWI), Proton MR spectroscopy (MRS), Perfusion MRI, and ultra-high-field MRI are emerging as promising tools for improving our understanding of the pathophysiology of MS.