Multiple Sclerosis
MRI of the spine and brain is the most important criterion for the diagnosis of multiple sclerosis (MS), a chronic inflammatory autoimmune disease of the nervous system. Besides the brain, multiple sclerosis can also occur in the spinal cord.The relevant demarking of the nervous system that occurs in multiple sclerosis can be very well visualized as lesions on MRI. Lesions are localized inflammations that have been caused by this process.
Due to the different weightings of the MRI, the lesions can be assessed by their different degrees of illumination or darkening, in order to estimate the severity of the disease. According to certain criteria, the McDonald criteria, newly occurring lesions are assessed by MRI in terms of time and space. Here it is considered that the presence of some lesions already in the MRI at the beginning of the symptomatology is considered an unfavorable prognosis.
MRI becomes relevant in the early diagnosis of multiple sclerosis. In a phase in which a neurological examination or control of the cerebral fluid does not yet provide evidence of multiple sclerosis, an MRI may already show lesions. It is therefore advisable to perform an MRI even at the slightest suspicion without clear clinical and laboratory signs.
An MRI with suspected multiple sclerosis should be performed with contrast medium (usually gadolinium). Since MS foci are metabolically active lesions and the contrast agent accumulates mainly in the metabolically active tissue, it can highlight the lesions even more on the image or even reveal foci that would otherwise not be visible. If there are risk factors for the contrast agent, a so-called native MRI, i.e. without contrast agent, is also sufficient.
The relevance of MRI is also characterized by the fact that the symptoms of a patient with multiple sclerosis can be assigned to the localizations in the MRI and thus explained. The symptoms are therefore neurological deficits in the areas where these foci are located.
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