Magnetic Resonance Imaging of Optic Nerve Pathologies
Summary
Magnetic resonance imaging (MRI) has emerged as an indispensable tool for the assessment of optic nerve disorders, offering non-invasive insights into inflammation, demyelination, ischaemia and structural atrophy. Modern high-resolution sequences permit detailed visualisation of the intraorbital and intracranial segments of the nerve, overcoming challenges of small calibre, orbital fat and susceptibility artefacts. Contrast-enhanced T1-weighted techniques reveal breakdown of the blood–nerve barrier in acute optic neuritis and related conditions, while fluid-sensitive sequences such as T2-weighted, FLAIR and STIR detect oedema and demyelinating lesions. Diffusion-weighted and diffusion-tensor approaches quantify axonal integrity and can distinguish neuromyelitis optica, multiple sclerosis and myelin oligodendrocyte glycoprotein-related neuropathies. Technical refinements continue to improve sensitivity and specificity, guiding early therapy, prognosis and longitudinal monitoring across a spectrum of optic nerve pathologies worldwide.
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Magnetic Resonance Imaging of Optic Nerve Pathologies publication trend
The graph below shows the total number of articles in magnetic resonance imaging of optic nerve pathologies across all publications each year (not limited to Nature Index journals).
Technical terms
Contrast enhancement: Increased signal on T1-weighted images after gadolinium administration, indicating breakdown of the blood–nerve barrier.
Fat suppression: A technique that nulls orbital fat signal on T1- or T2-weighted sequences to improve nerve conspicuity.
FLAIR (Fluid-Attenuated Inversion Recovery): A T2-weighted sequence with CSF signal nulling to highlight parenchymal lesions adjacent to fluid spaces.
STIR (Short Tau Inversion Recovery): A fat-suppressed T2-weighted method that enhances detection of oedema and demyelination within the optic nerve.
Diffusion-Weighted Imaging (DWI): Measures Brownian motion of water molecules, aiding in the detection of acute ischaemia and microstructural integrity.
References
- Radiologic Predictors of Visual Outcome in Myelin Oligodendrocyte Glycoprotein-Related Optic Neuritis. Ophthalmology (2024).
- Gadolinium-Enhanced 3D T1-Weighted Black-Blood MR Imaging for the Detection of Acute Optic Neuritis. American Journal of Neuroradiology (2020).
- Dedicated 3D-T2-STIR-ZOOMit Imaging Improves Demyelinating Lesion Detection in the Anterior Visual Pathways of Patients with Multiple Sclerosis. American Journal of Neuroradiology (2021).
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