Magnetic Resonance Imaging Applications in Multiple Sclerosis
Summary
Magnetic resonance imaging (MRI) has become indispensable in the diagnosis, monitoring and management of multiple sclerosis (MS). Early in the disease course, conventional T1-weighted and T2-weighted protocols detect characteristic periventricular, juxtacortical and infratentorial lesions, providing evidence for dissemination in space and time. The use of contrast-enhanced sequences further distinguishes active inflammatory foci from chronic plaques, informing both prognosis and treatment decisions. Beyond lesion counting, quantitative MRI techniques such as diffusion-weighted imaging and magnetisation transfer ratio mapping offer insights into microstructural damage and tissue integrity, correlating with disability scales. Spinal cord imaging poses unique challenges, but advanced three-dimensional sequences now allow robust detection of cord lesions that were previously occult, improving diagnostic certainty in patients with spinal presentations. Standardisation efforts have produced consensus protocols for scan acquisition and reporting, ensuring reproducibility across centres and facilitating the evaluation of emerging therapies. Together, these developments underscore the global significance of MRI as both a clinical and research tool in MS, enabling personalised care and rigorous assessment of novel interventions.
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Magnetic Resonance Imaging Applications in Multiple Sclerosis publication trend
The graph below shows the total number of articles in magnetic resonance imaging applications in multiple sclerosis across all publications each year (not limited to Nature Index journals).
Technical terms
Demyelinating lesion: An area of myelin loss in the central nervous system visible as abnormal signal on MRI sequences.
Contrast-enhanced MRI: Imaging performed after intravenous administration of gadolinium-based agents to highlight active inflammatory lesions by altering local magnetic properties.
Phase-sensitive inversion recovery (PSIR): A T1-weighted technique that uses phase information to suppress background signals and increase lesion conspicuity.
3D MP2RAGE: A three-dimensional magnetisation-prepared sequence providing uniform T1-weighted contrast and high spatial resolution for improved tissue differentiation.
References
- MRI in the Diagnosis and Monitoring of Multiple Sclerosis: An Update. Clinical Neuroradiology (2015).
- MR Imaging in Multiple Sclerosis: Review and Recommendations for Current Practice. American Journal of Neuroradiology (2009).
- Reduced Diffusion in a Subset of Acute MS Lesions: A Serial Multiparametric MRI Study. American Journal of Neuroradiology (2012).
- Accuracy of Postcontrast 3D Turbo Spin-Echo MR Sequence for the Detection of Enhanced Inflammatory Lesions in Patients with Multiple Sclerosis. American Journal of Neuroradiology (2013).
- Canadian Expert Panel Recommendations for MRI Use in MS Diagnosis and Monitoring. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques (2015).
- Association between clinic-level quality of care and patient-level outcomes in multiple sclerosis. Multiple Sclerosis Journal (2023).
- A 3T Phase-Sensitive Inversion Recovery MRI Sequence Improves Detection of Cervical Spinal Cord Lesions and Shows Active Lesions in Patients with Multiple Sclerosis. American Journal of Neuroradiology (2019).
- Improved Cervical Cord Lesion Detection with 3D-MP2RAGE Sequence in Patients with Multiple Sclerosis. American Journal of Neuroradiology (2020).
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