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T 1-weighted images, left image without, right image with contrast medium administration. Gadolinium(III) containing MRI contrast agents (often termed simply "gado" or "gad") are the most commonly used for enhancement of vessels in MR angiography or for brain tumor enhancement associated with the degradation of the blood–brain barrier (BBB).
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves to form images of the organs in the body.
Unusual types of MS have been described; these include Devic's disease, Balo concentric sclerosis, Schilder's diffuse sclerosis, and Marburg multiple sclerosis. There is debate on whether they are MS variants or different diseases. [31] Multiple sclerosis behaves differently in children, taking more time to reach the progressive stage. [5]
Therefore, clinically assisted diagnostic criteria are still required for a more accurate MS diagnosis than MRI alone. [97] The lesion evolution under MRI has been reported to begin as a pattern of central hyperintensity. This was seen in the majority of new lesions, both on proton density and contrast-enhanced T1-weighted images. [98]
Currently, routine clinical follow-up and MRI neuroimaging surveillance is the standard by which patients are observed. [4] While treatment of MS disease modifying therapies have been given to some individuals with RIS, the majority opt for active surveillance and the appearance of clinical symptoms before commencing treatment, [5] as treatment is considered controversial.
Diffusion imaging is an MRI method that produces in vivo magnetic resonance images of biological tissues sensitized with the local characteristics of molecular diffusion, generally water (but other moieties can also be investigated using MR spectroscopic approaches). [15] MRI can be made sensitive to the motion of molecules.
Among the imaging biomarkers in MS the most known is MRI by two methods, gadolinium contrast and T2-hypertense lesions, but also important are PET and OCT. Among the body fluid biomarkers the most known are oligoclonal bands in CSF but several others are under research. Genetic biomarkers are under study but there is nothing conclusive still.
At five year follow-ups the overall risk of developing MS is 30%, with or without MRI lesions. Patients with a normal MRI still develop MS (16%), but at a lower rate compared to those patients with three or more MRI lesions (51%).