Magnetic resonance imaging (MRI) is one of the diagnostic tools used to monitor multiple sclerosis patients. It is a non-invasive way of looking at the brain and spinal cord to detect new lesions and to determine how the disease is progressing.
According to the National MS Society, MRI uses radio waves and magnetic fields to measure water content in normal and abnormal tissue in the body. This data is then fed to a computer where it’s translated into images of the water in the tissue in the scanned areas. There are different types of MRI scans which produce slightly different images.
The layer of myelin that protects the fibers in the nerve cell is fatty so it repels water. In areas where myelin has been stripped away due to the progression of MS, the fat is reduced and the tissue contains more water. This shows up on the MRI as either a darker area or a bright white patch depending on the type of MRI.
MRI scans are useful for detecting demyelination which shows how fast the multiple sclerosis is progressing. If repeated MRI scans do not detect lesions or demyelination, it’s unlikely that the patient has MS.
MRI scans are not infallible. As demyelination may occur in areas of the brain that are considered silent (in that they do not produce symptoms in the patient), the MRI results may not offer a correlation between the images and the symptoms experienced by the patient. People over the age of 50 may also show what looks like MS activity on an MRI scan but it’s not due to demyelination, but rather the natural aging process, and is not an indication of MS.
When it comes to distinguishing between MS and clinically isolated syndrome (CIS) — where a single incident of brain lesions has occurred — MRI scans can prove to be very useful, as doctors are able to more accurately predict if the patient is likely to develop MS.
Once a definite diagnosis of multiple sclerosis has been reached, MRI scans are an important part of tracking the progression of the disease and patients are advised to have them regularly to ensure they are on the correct treatment.
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