Rovira Cañellas A
Departamento de Radiología, Hospitals Vall d'Hebron, Barcelona.
Neurologia. 2000 Aug-Sep;15(7):288-302.
Although the diagnosis of multiple sclerosis is still based on clinical criteria, confirmation by magnetic resonance imaging (MRI) is considered to be essential, thank to its high sensitivity in demonstrating the spatial dissemination of the demyelinating plaques in the brain and spinal cord. Additionally, MRI can establish an approximation of the pathological substrate of the multiple sclerosis plaques and it has proven useful for studying the natural history of the disease and monitoring the effects of new treatments. This capacity of MRI is based on its ability to estimate the degree of demyelination, gliosis, edema, inflammation and axonal damage and to detect diffuse involvement of the normal appearing white matter. The selective identification of the lesions that contribute most to the patient's disability and clinical progression, such as severe demyelination and axonal damage, improves the MRI correlation with the neurological impairment scales. However, a correct application of MRI in the study of multiple sclerosis requires standardization of the techniques and sequences used in the different clinical forms of the disease and of the systems for measuring the lesion load. In this way multiple sclerosis can serve as a true biological marker of the severity of the disease.
尽管多发性硬化症的诊断仍基于临床标准，但磁共振成像（MRI）的确认被认为是必不可少的，这得益于其在显示脑和脊髓脱髓鞘斑块的空间播散方面的高敏感性。此外，MRI可以对多发性硬化症斑块的病理基础进行近似评估，并且已证明对研究疾病的自然史和监测新治疗方法的效果很有用。MRI的这种能力基于其估计脱髓鞘、胶质增生、水肿、炎症和轴突损伤程度以及检测正常外观白质弥漫性受累的能力。对导致患者残疾和临床进展的病变（如严重脱髓鞘和轴突损伤）进行选择性识别，可提高MRI与神经功能损害量表的相关性。然而，在多发性硬化症研究中正确应用MRI需要对该疾病不同临床形式中使用的技术和序列以及测量病变负荷的系统进行标准化。通过这种方式，多发性硬化症可以作为疾病严重程度的真正生物学标志物。
