Filippi Massimo, Rocca Maria A, Rovaris Marco
Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy.
Curr Neurol Neurosci Rep. 2002 May;2(3):267-76. doi: 10.1007/s11910-002-0086-2.
Conventional magnetic resonance imaging (cMRI) is widely used for diagnosing multiple sclerosis (MS) and as a paraclinical tool to monitor disease activity and evolution in natural history studies and clinical trials. However, the correlation between cMRI and clinical findings is far from strict, and such a discrepancy is even more evident when moving from the setting of large-scale studies to the management of individual patients. Among the reasons for this "clinical-MRI paradox" is the limited specificity of cMRI to the heterogeneous pathologic substrates of MS and its inability to quantify the extent of damage in the normal-appearing tissues. Modern quantitative MR techniques have the potential to overcome some of the limitations of cMRI. Although the application of modern MR techniques is changing dramatically our understanding of how MS causes irreversible disability, their use for clinical trial monitoring and clinical practice is still very limited. Whereas there is increasing perception that modern quantitative MR techniques should be more extensively employed in clinical trials to advance the understanding of MS and derive innovative information, their use in clinical practice should still be regarded as premature.
传统磁共振成像（cMRI）被广泛用于诊断多发性硬化症（MS），并作为一种辅助临床工具，在自然史研究和临床试验中监测疾病活动及进展。然而，cMRI与临床发现之间的相关性并不严格，当从大规模研究转向个体患者的管理时，这种差异更加明显。造成这种“临床-磁共振成像悖论”的原因之一是cMRI对MS异质性病理基质的特异性有限，且无法量化外观正常组织中的损伤程度。现代定量磁共振技术有可能克服cMRI的一些局限性。尽管现代磁共振技术的应用正在极大地改变我们对MS如何导致不可逆残疾的理解，但其在临床试验监测和临床实践中的应用仍然非常有限。虽然越来越多的人认为现代定量磁共振技术应在临床试验中更广泛地应用，以增进对MS的理解并获取创新信息，但其在临床实践中的应用仍应被视为为时过早。
