Neuroimaging clinics of North America
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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
ReviewPediatric Multiple Sclerosis: Distinguishing Clinical and MR Imaging Features.
This article presents an overview of evolving diagnostic criteria of pediatric multiple sclerosis and related disorders, emphasizing distinguishing clinical and neuroimaging features that should be considered for differential diagnosis in childhood and adolescence. New data on the integrity of brain tissue in children with MS provided by advanced MR imaging techniques are addressed as well.
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Neuroimaging Clin. N. Am. · May 2017
ReviewMultiple Sclerosis: Epidemiologic, Clinical, and Therapeutic Aspects.
Multiple sclerosis (MS) is a chronic autoimmune and degenerative disease of the central nervous system that affects young people. MS develops in genetically susceptible individuals exposed to different unknown triggering factors. Different phenotypes are described. ⋯ An increasing number of disease-modifying treatments has emerged. Although encouraging, the number of drugs challenges the neurologist because each treatment has its own risk-benefit profile. Patients should be involved in the decision-making process to ensure good treatment and safety monitoring adherence.
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Neuroimaging Clin. N. Am. · May 2017
ReviewMicrostructural MR Imaging Techniques in Multiple Sclerosis.
Due to its sensitivity in the detection of focal white matter (WM) lesions, MR imaging has become a paraclinical tool central to diagnosing multiple sclerosis (MS) and monitoring its evolution. Despite this, the correlation between patients' clinical status and conventional MR imaging measures is weak to moderate. Quantitative MR imaging-based techniques, such as magnetization transfer and diffusion tensor imaging, have a higher specificity toward the heterogeneous pathologic substrates of MS than MR imaging. This article discusses the main insights derived from the application of such MR imaging-based techniques to define MS pathophysiology and to quantify the progressive accumulation of structural damage in the central nervous system.
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Neuroimaging Clin. N. Am. · May 2017
ReviewRadiologically Isolated Syndrome: MR Imaging Features Suggestive of Multiple Sclerosis Prior to First Symptom Onset.
Remarkable advances in the understanding of the biology of multiple sclerosis have been achieved through the use of conventional and novel MR imaging techniques of the central nervous system. With improvements in access by patients and utilization of MR imaging technology in health care, an increasing number of unanticipated structural anomalies are being appreciated. In certain instances, white matter abnormalities within the brain and spinal cord are discovered in subjects with no prior history of neurologic symptoms supportive of inflammatory demyelinating events.