Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2017
ReviewBrain Atrophy in Multiple Sclerosis: Clinical Relevance and Technical Aspects.
There is evidence of a neurodegenerative process running in parallel with or as a consequence of the inflammatory phenomenon in multiple sclerosis (MS). MR imaging has been central in the generation of such knowledge and has played a pivotal role in investigating the neurodegenerative process. However, there is insufficient evidence supporting MR imaging-measured brain atrophy as a biomarker of the neurodegenerative component of MS in the daily care of patients with MS. This article discusses the prognostic value of brain volume measurements and their potential role in monitoring treatment response in patients with MS.
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Several neuropathologic and imaging studies have consistently confirmed that multiple sclerosis affects both white (WM) and gray matter (GM) and that GM damage plays a key role in disability progression. However, differently from WM damage, the less inflammatory cell infiltration, the absence of significant blood-brain barrier damage, the low myelin density in upper cortical layers, as well as technical constraints, make the GM damage almost undetectable by means of conventional MR imaging.
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Neuroimaging Clin. N. Am. · May 2017
ReviewInsights from Ultrahigh Field Imaging in Multiple Sclerosis.
Ultrahigh-field (≥7 T) magnetic resonance (MR) imaging is being used at many leading academic medical centers to study neurologic disorders. The improved spatial resolution and anatomic detail are due to the increase in signal-to-noise and contrast-to-noise ratio at higher magnetic field strengths. Ultrahigh-field MR imaging improves multiple sclerosis (MS) lesion detection, with particular sensitivity to detect cortical lesions. The increase in magnetic susceptibility effects inherent to ultrahigh field can be used to detect pathologic features of MS lesions, including a central vein, potentially useful for diagnostic considerations, and heterogeneity among MS lesions, potentially useful in determining lesion outcomes.