MRI in multiple sclerosis: diagnosis, symptoms
MRI diagnostics allows you to visualize and detect various disorders of the structure of the brain and spinal cord that occur in patients suffering from multiple sclerosis. Often scanning is becoming a key factor in diagnosis. Thanks to the powerful magnetic field of the device during MRI is the response of the nuclei of hydrogen atoms from the cells and tissues of the body. Because diseased brain tissue respond differently to the magnetic influence than healthy tissue, magnetic resonance tomography is currently the most accurate method in the differential diagnosis.
Diagnosis of multiple sclerosis
In the early stages of multiple sclerosis does not manifest the characteristics. Why diagnosis of the disease is quite difficult. On examination, the physician may identify a neurological disorder of the disease, assess the patient’s condition and degree of disability. Without an MRI examination to identify lesions in the brain and spinal cord cannot. To eliminate false results and to differentiate the disease, MRI is performed with contrast. The patient is administered a drug that can increase the performance of the survey.
The most accurate diagnosis when MRI of brain and spinal cord in multiple sclerosis are possible using two time contrasts T1 and T2 modes. MRI in T1 mode, from the white substance of the spinal cord and brain assumes the light signal. Pockets ruined shell neural pathways, do not show intensity. The image contrast looks like dark pockets. This indicates the presence of axonal degeneration characteristic of multiple sclerosis.
To deliver a more accurate diagnosis, to assess the lesions and the lesion of the mode T2. In the process of scanning in this mode, the area of destruction of the myelin sheath of nerve pathways turn out on the image as bright spots, and white matter emits dark signal.
After scanning, doctors can assess pathological processes. In order to visualize small lesions injected contrast agent gadolinium, which enhances the intensity of the incoming signals. After injection of contrast occurs its accumulation in the affected areas. This indicates the exacerbation of inflammatory processes in brain tissue.
Assessment of the patient’s condition
Due to its unique ability to visualize lesions of the brain and spinal cord MRI can show the pathophysiology of multiple sclerosis. After scanning, determine whether symptoms are the result of diffuse lesions of the brain and spinal cord or is it local to certain pockets. Through MRI the doctor may make a diagnosis and to determine the phase of the disease, the first signs of disease.
Diagnosis MRI has advantages over computed tomography as it allows you to make slices in three planes. High field, the device can detect signs of multiple sclerosis even in the thoracic spinal cord. Diagnosis is particularly indicated in cases where the patient already had several attacks of illness, but electrophysiological studies revealed only isolated pathological lesion in the Central nervous system. Exact diagnosis is made after visualization of multiple abnormalities in the white matter of brain and spinal cord.
When you scan, radiologists can see a typical picture of multiple sclerosis and to diagnose. Allocate a special combination of electrophysiological, pathological and clinical combinations of disease that are characteristic of a particular syndrome:
- acute inflammatory demyelination;
- chronic inflammatory demyelination;
- multifocal-leukoencephalopathy degenerative;
- combined multifocal diffuse leukoencephalopathy.
The most common syndrome of acute inflammatory demyelination. In chronic inflammatory demyelination prevail large pockets with edema, which can lead to compression of the brain. The syndrome of multifocal degenerative leukoencephalopathy in the pictures are displayed small foci on the background of atrophy. For the syndrome of combined multifocal diffuse leukoencephalopathy the characteristic of a typical mnogozadachnosti with diffuse lesions of the white matter. This pattern is typical for severe course of the disease and can talk about the inherent defects in glial cells and nerve tissue.
MRI diagnostics allows not only to confirm the diagnosis, to identify the first signs of multiple sclerosis, to see even small lesions in the brain and spinal cord. Scanning is the most promising for monitoring the effectiveness of treatment. Repeated examination of the patient show that the area of demyelination can vary in size. Some pathological lesions disappear completely after treatment, some of them arise in another place. It all depends on the reduction of swelling and inflammation in the diseased areas.
Magnetic resonance imaging in multiple sclerosis allows to detect the formation of new lesions, the appearance of a now-vanished pathological areas and increasing the existing after treatment. In clinical examinations such pathological changes are detected 10 times less.
When monitoring each rescan should take into account the standard set of pulse sequences to avoid errors when determining the size of pathological areas. Thus, magnetic resonance imaging greatly contributes to the diagnosis of multiple sclerosis in doubtful cases, it helps to assess the patient’s condition after treatment, identifies new areas of demyelination.