Magnetic Resonance Imaging in Multiple Sclerosis Diagnostics
Summary
Multiple sclerosis (MS) is an inflammatory demyelinating disorder of the central nervous system that requires early and accurate detection to inform treatment and prognosis. Magnetic resonance imaging (MRI) has become the cornerstone of MS diagnostics, integrating conventional sequences—T1-weighted, T2-weighted and fluid-attenuated inversion recovery (FLAIR)—with advanced modalities such as susceptibility-weighted imaging, diffusion tensor imaging and magnetisation transfer imaging. High-field (3 T) and ultrahigh-field (7 T) scanners enhance spatial resolution and contrast, enabling visualisation of key features such as the central vein sign and paramagnetic rims. Quantitative metrics, including lesion volume, myelin water fraction and iron deposition, correlate with clinical disability, cognitive impairment and disease progression. Recent advances in automated and machine learning-based pipelines facilitate standardised lesion segmentation and classification of cortical, periventricular and paramagnetic rim lesions. Together, these developments have improved diagnostic specificity by distinguishing MS from mimics, refined monitoring of inflammatory activity, and supported personalised therapeutic decision-making.
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Magnetic Resonance Imaging in Multiple Sclerosis Diagnostics publication trend
The graph below shows the total number of articles in magnetic resonance imaging in multiple sclerosis diagnostics across all publications each year (not limited to Nature Index journals).
Technical terms
Central vein sign: Appearance of a small vein coursing through the centre of a white matter lesion on susceptibility-sensitive MRI, characteristic of MS plaques.
Fluid-attenuated inversion recovery (FLAIR): An MRI sequence that suppresses cerebrospinal fluid signal to highlight periventricular and cortical lesions.
Susceptibility-weighted imaging (SWI): An MRI technique sensitive to magnetic susceptibility differences, used to visualise venous structures and iron deposition.
Paramagnetic rim lesion: A chronic lesion marked by a peripheral ring of iron-laden microglia visible on susceptibility-sensitive sequences.
Cortical lesion: A demyelinated focus within the cerebral cortex, detectable with high-resolution or specialised MRI protocols but often occult on conventional scans.
References
- The Use of the Central Vein Sign in the Diagnosis of Multiple Sclerosis: A Systematic Review and Meta-analysis. Diagnostics (2020).
- Automated Integration of Multimodal MRI for the Probabilistic Detection of the Central Vein Sign in White Matter Lesions. American Journal of Neuroradiology (2018).
- Ultrahigh field MRI in clinical neuroimmunology: a potential contribution to improved diagnostics and personalised disease management. EPMA Journal (2015).
- Cortical lesions, central vein sign, and paramagnetic rim lesions in multiple sclerosis: Emerging machine learning techniques and future avenues. NeuroImage Clinical (2022).
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