Multiple sclerosis (MS) is a serious health condition that gets worse over time. In this disease, the body’s natural guard against illness (the immune system) damages fatty coverings called myelin sheaths around the axons of cells called neurons in the central nervous system. The disease makes people’s bodies, eyesight, speech, and minds work poorly. People with MS do not normally live as long as healthy people.
In healthy people, myelin sheaths help neurons work. Electric signals in neurons move quickly through long, narrow axons like electricity in a wire. The myelin is like the insulator around the wire that keeps the signal strong by keeping it from moving out of the wire before the end. A person with MS has myelin that is too thin or completely gone. Without the protective covering, the signals between neurons do not travel well. Because of this, the mind and body cannot work like they normally do.
A new way of using MRI scanners to look for evidence of multiple sclerosis in the brain has been successfully tested by researchers at The University of Nottingham and Nottingham University Hospitals NHS Trust.
Multiple sclerosis (MS) is a neurological condition which affects many people in the world. It is notoriously difficult to diagnose as it has many symptoms but not all sufferers experience all of them and the disease can progress at different rates. MRI scans have been used as a diagnostic tool to detect white matter lesions in the brain but these are not always an indicator of the disease.
Now a research team at Nottingham has found a way to use clinical MRI to distinguish between MS lesions and other brain white spots which are found in MS. The study is published in the Multiple Sclerosis Journal.
They have used a clinical MRI scanner of the type all neuroscience centres have to carry out a special type of scan called a T2-weighted imaging process which is able to reveal lesions in the brain’s white matter that are centred on a vein — a known indicator of MS.
New MRI technique offers faster diagnosis of multiple sclerosis
Background: White matter lesions are frequently detected using brain magnetic resonance imaging (MRI) performed for various indications. Most are microangiopathic, but demyelination, including multiple sclerosis (MS), is an important cause; conventional MRI cannot always distinguish between these pathologies. The proportion of lesions with a central vein on 7-T T2*-weighted MRI prospectively distinguishes demyelination from microangiopathic lesions.
Objective: To test whether 3-T T2*-weighted MRI can differentiate MS from microangiopathic brain lesions.
Methods: A total of 40 patients were studied. Initially, a test cohort of 10 patients with MS and 10 patients with microangiopathic white matter lesions underwent 3-T T2*-weighted brain MRI. Anonymised scans were analysed blind to clinical data, and simple diagnostic rules were devised. These rules were applied to a validation cohort of 20 patients (13 with MS and 7 with microangiopathic lesions) by a blinded observer.
Results: Within the test cohort, all patients with MS had central veins visible in >45% of brain lesions, while the rest had central veins visible in <45% of lesions. By applying diagnostic rules to the validation cohort, all remaining patients were correctly categorised.
Conclusion: 3-T T2*-weighted brain MRI distinguishes perivenous MS lesions from microangiopathic lesions. Clinical application of this technique could supplement existing diagnostic algorithms.
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