A magnetic resonance imaging (MRI) scan is the most sensitive method available to detect lesions and show changes in the central nervous system typical of Multiple Sclerosis (MS). MRI can detect more than one lesion in 90 percent of people with MS. It can be used to confirm a diagnosis of MS and to see if the disease has worsened.
MRI is particularly useful if symptoms change suddenly. MRI is extremely sensitive and can detect very small lesions. Sometimes a contrast dye (gadolinium enhancement) is injected into a vein to see if the protective blood-brain barrier has been broken, a common abnormality in people with MS, especially during an attack. Gadolinium enhancement also shows new activity. In some cases, MRI will be normal even though a physical and neurological examination suggests MS.
How does MRI work?
The imaging device circles the body and uses magnets to oscillate water molecules, then picks up the signals that are released by water to produce a detailed picture of the water content of tissues. This gives rise to an image that can show the brain and spinal cord with great clarity.
Why is MRI important?
Because noticeable MS exacerbations are infrequent (usually fewer than one a year) and visible disability occurs slowly, a diagnosis based on symptoms and signs alone is difficult and often delayed. Thus, physicians have come to rely on MRI, which can provide 3-dimensional images of the brain, to detect MS and differentiate it from other illnesses that may have similar symptoms. It has also been shown that MRI is 7 to 10 times more sensitive for detecting MS progression than clinical assessment alone.
Recently, doctors have started to use serial MRIs (performed over time) to monitor the course of illness and identify which MS patients will benefit most from early treatment.
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