Magnetic Resonance in Multiple Sclerosis

by David H. Miller , Jürg Kesselring , W. Ian McDonald , Donald W. Paty , Alan J. Thompson

• ISBN13: 9780521473255
• ISBN10: 052147325X
• Format: Hardcover
• Copyright: 1997-09-28
• Publisher: Cambridge University Press

Summary

Magnetic resonance (MR) imaging and spectroscopy are powerful tools in demonstrating and monitoring pathological processes of the brain and spinal cord. Multiple sclerosis (MS), a common and as yet incurable disease of the brain and spinal cord, is being studied intensively using these techniques. They perform a major role in facilitating the diagnosis, understanding the mechanisms of symptoms and in monitoring the effect of new treatments. From experts in the field, this extensively illustrated text provides a comprehensive review of the benefits and limitations of MR in the study of MS. Coverage ranges through the contributions of MR, the variety of techniques available, diagnosis and differential diagnosis, MR as a predictor of clinical course, MR views of pathophysiology and finally monitoring new treatment efficacy. This book will prove an invaluable aid to all neurologists, neuroradiologists and neuroscientists with an interest in MS.

Table of Contents

Chapter 1 The impact of magnetic resonance in multiple sclerosis	1	(8)
W Ian McDonald
1.1 Introduction	1	(1)
1.2 The contribution of MRI	1	(6)
1.3 Is our enthusiasm justified?	7	(2)
Chapter 2 Magnetic resonance techniques relevant to the study of multiple sclerosis	9	(24)
David H Miller
2.1 General remarks	9	(1)
2.2 Brain MRI	10	(8)
2.3 Spinal cord MRI	18	(4)
2.4 Optic nerve MRI	22	(4)
2.5 MR spectroscopy	26	(2)
2.6 Image analysis	28	(5)
Chapter 3 Spectrum of abnormalities in multiple sclerosis	33	(30)
David H Miller
3.1 Use of MRI in diagnosis	31	(2)
3.2 Brain MRI in clinically definite multiple sclerosis	33	(7)
3.3 Evolution of lesions	40	(5)
3.4 Spinal cord MRI	45	(1)
3.5 Optic neuritis	46	(4)
3.6 Special clinical settings	50	(10)
3.7 New MR techniques to assist diagnosis	60	(2)
3.8 Conclusion	62	(1)
Chapter 4 Differential diagnosis	63	(45)
Jurg Kesselring
David H Miller
4.1 Introduction	63	(1)
4.2 MRI in healthy persons in various age groups	63	(4)
4.3 Non-inflammatory vascular syndromes	67	(2)
4.4 Collagen vascular disorders	69	(7)
4.5 Sarcoidosis	76	(3)
4.6 Acute disseminated encephalomyelitis	79	(4)
4.7 Devic's neuromyelitis optica	83	(3)
4.8 Leucodystrophies	86	(2)
4.9 Degenerative ataxic disorders	88	(2)
4.10 HTLV-1 associated myelopathy	90	(2)
4.11 Leber's hereditary optic neuropathy	92	(1)
4.12 Acute intermittent porphyria	93	(1)
4.13 Whipple's disease	94	(1)
4.14 Motor neurone disease	94	(3)
4.15 Subacute combined degeneration of the spinal cord	97	(1)
4.16 Wilson's disease	97	(2)
4.17 Phenylketonuria	99	(1)
4.18 Mitochondrial disease	99	(1)
4.19 Progressive multifocal leucoencephalopathy	100	(1)
4.20 Subacute sclerosing panencephalitis	100	(1)
4.21 HIV encephalitis	101	(1)
4.22 Radiation- or chemotherapy-induced leucoencephalopathy	101	(1)
4.23 Trauma	101	(2)
4.24 Lyme disease	103	(1)
4.25 Structural abnormalities of the brain stem, foramen magnum and spinal cord	104	(4)
Chapter 5 Assigning prognosis	108	(18)
David H Miller
5.1 Introduction	108	(1)
5.2 MRI abnormalities in healthy individuals	109	(1)
5.3 MRI in healthy relatives of patients with multiple sclerosis	109	(1)
5.4 MRI in clinically isolated syndromes: risk for developing multiple sclerosis	110	(7)
5.5 MRI in clinically isolated syndromes: risk for disability	117	(1)
5.6 MRI in established multiple sclerosis: risk for disability	117	(9)
Chapter 6 Pathogenesis and mechanisms of disability	126	(21)
Alan J Thompson
6.1 MR/pathology correlates	126	(2)
6.2 MR studies in experimental allergic encephalomyelitis	128	(1)
6.3 Early lesions in multiple sclerosis	129	(1)
6.4 The relationship between PD/T(2)-weighted abnormality, gadolinium enhancement and clinical activity	130	(2)
6.5 MRI and clinical subgroups	132	(2)
6.6 Serial MRI studies in clinical subgroups	134	(3)
6.7 Cognitive/MRI correlates	137	(2)
6.8 Mechanisms underlying acute relapse	139	(1)
6.9 The development of disability	140	(6)
6.10 Conclusion	146	(1)
Chapter 7 Monitoring treatment trials	147	(25)
Donald W Paty
David H Miller
7.1 Introduction	147	(1)
7.2 Natural history serial studies	147	(9)
7.3 Clinical MRI correlations: implications for treatment trials	156	(1)
7.4 Recent use of MRI in clinical trials	157	(9)
7.5 A guide to the application of MR techniques in therapeutic trials	166	(6)
Appendix 1 Preliminary trials in established multiple sclerosis	172	(1)
Appendix 2 Definitive trials in established multiple sclerosis	173	(1)
Appendix 3 Trials in clinically isolated syndromes	174	(1)
References	175	(18)
Index	193