Neuroimaging Research Unit, Division of Neuroscience, Scientific Institute and University Hospital San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
Radiology. 2011 Jun;259(3):659-81. doi: 10.1148/radiol.11101362.
Owing to its ability to depict the pathologic features of multiple sclerosis (MS) in exquisite detail, conventional magnetic resonance (MR) imaging has become an established tool in the diagnosis of this disease and in monitoring its evolution. MR imaging has been formally included in the diagnostic work-up of patients who present with a clinically isolated syndrome suggestive of MS, and ad hoc diagnostic criteria have been proposed and are updated on a regular basis. In patients with established MS and in those participating in treatment trials, examinations performed with conventional MR pulse sequences provide objective measures to monitor disease activity and progression; however, they have a limited prognostic role. This has driven the application of newer MR imaging technologies, including higher-field-strength MR units, to estimate overall MS burden and mechanisms of recovery in patients at different stages of the disease. These techniques have allowed in vivo assessment of the heterogeneity of MS pathologic features in focal lesions and in normal-appearing tissues. More recently, some of the finer details of MS, including macrophage infiltration and abnormal iron deposition, have become quantifiable with MR imaging. The utility of these modern MR techniques in clinical trial monitoring and in the assessment of the individual patient's response to treatment still need to be evaluated.
由于其能够非常详细地描绘多发性硬化症 (MS) 的病理特征，传统磁共振成像 (MR) 已成为诊断该病和监测其演变的既定工具。MR 成像已正式纳入具有 MS 临床孤立综合征表现的患者的诊断程序，并且已经提出了专门的诊断标准，并定期进行更新。在已确诊的 MS 患者和参与治疗试验的患者中，使用常规 MR 脉冲序列进行的检查可提供客观的指标来监测疾病的活动和进展；然而，它们的预后作用有限。这推动了应用更新的 MR 成像技术，包括更高场强的 MR 设备，以估计不同疾病阶段患者的总体 MS 负担和恢复机制。这些技术允许在体内评估局灶性病变和正常表现组织中 MS 病理特征的异质性。最近，一些 MS 的更细微细节，包括巨噬细胞浸润和异常铁沉积，已经可以通过 MR 成像来量化。这些现代 MR 技术在临床试验监测和评估个体患者对治疗的反应中的效用仍需要进行评估。
