Multiple sclerosis is a chronic disease that damages myelin, the covering that protects nerve cells in the human brain and spinal cord. The injury can be seen on an MRI.
These changes disrupt communication between the brain and the rest of the body and cause a variety of symptoms.
Symptoms vary from person to person, but may include pain and stiffness in the limbs, vision problems, bowel and bladder problems, difficulty walking, fatigue, and weakness or numbness in the body.
There is currently no cure for multiple sclerosis (MS), but in some cases, medications can improve long-term outcomes. The current recommendation is to start treatment as soon as possible for maximum effect.
However, for this it is very important to establish an accurate diagnosis. No single test can accurately diagnose multiple sclerosis, but imaging tests and analysis of cerebrospinal fluid can help doctors identify the disease.
Doctors often use MRIs to examine the brain and spinal cord, looking for changes that may indicate multiple sclerosis.
Radiology for the diagnosis of multiple sclerosis
Doctors don’t know exactly why multiple sclerosis develops, but it occurs when the immune system mistakenly attacks the myelin sheath that protects nerve cells.
An MRI of the brain and spinal cord can show areas of injury or scarring.
MS can be difficult to diagnose because it shares symptoms with other diseases and does not affect everyone in the same way.
It is important to get a correct diagnosis as soon as possible so that appropriate treatment can be started.
Doctors use specific guidelines called the McDonald criteria to determine whether you have multiple sclerosis.
Before confirming a diagnosis of multiple sclerosis, doctors must look for changes or damage to at least two parts of the brain, spinal cord, or optic nerve.
There is also evidence that the damage to these wounds occurred at different times. Cysts that have been around for a while are usually different from cysts that have developed recently.
In addition, patients must have symptomatic episodes lasting more than 24 hours without resolution and without fever or signs of infection.
Exceptions to other terms
Other tests can help rule out other conditions that may have similar symptoms, such as:
- severe vitamin B-12 deficiency
- collagen vascular disease
- Guillain-Barré syndrome
In a specific type of multiple sclerosis called clinical isolation syndrome (CIS), a person may experience loss of function similar to multiple sclerosis, but not the other symptoms.
What do you expect
Before an MRI is performed, the patient must sign a consent form for the scan and the radiologist will ask a series of questions.
Because of the strong magnets, the technician may need to wear a gown and remove any metal jewelry, hearing aids, or metal objects.
People who wear pacemakers or have metal implanted need to know the details of these devices in order to explain them to a healthcare professional. Some equipment is allowed to be used during an MRI, while others are not.
The MRI examination is painless, but the generated magnetic field is very strong. The sound is like hitting and knocking. Earplugs can help make sound more manageable.
People with claustrophobia may feel uncomfortable or uncomfortable in a tube-like MRI machine. Some MRI machines are open and tunnelless, but they do not always provide high-quality images.
Therefore, many doctors recommend a tunnel MRI to rule out multiple sclerosis. Medications are sometimes given to patients before the test to reduce anxiety.
An MRI scan can take anywhere from 15 minutes to an hour or more.
After the examination, patients can usually return to their daily activities. If you are unconscious, you may need someone to help you get home.
How Does MRI Work for MS?
An MRI scan is an imaging test that uses magnetic fields and radio waves to create images to measure the amount of water in tissue. Exposure to radiation is not covered.
This is an effective, potential method that doctors can use to diagnose MS and track its progress.
MRI is helpful because MS destroys myelin, which is made up of fatty tissue.
Grease absorbs water like oil. When water content is measured with MRI, areas of damaged myelin are more clearly visible. Depending on the type or configuration of the MRI scanner, damaged areas in the scanned image may appear white or black.
Examples of the types of MRI sequences doctors use to diagnose multiple sclerosis include:
T1-weighted: The radiologist injects the person with a substance called gadolinium. Gadolinium particles are usually too large to pass through certain areas of the brain. However, if a person’s brain is damaged, the rash will grow from the damaged area. The lesion appears black on a T1-weighted scan, making it easier for doctors to identify.
T2-weighted scan: In a T2-weighted scan, the radiologist delivers individual pulses through the MRI machine. Old wounds look different in color than new ones. In contrast to T1-weighted scans, lesions appear brighter on T2-weighted images.
Fluid Attenuated Inversion Recovery (FLAIR): FLAIR images use a different set of pulses than T1 and T2 images. These images are very sensitive to the brain damage that MS typically causes.
Spinal cord imaging: By using an MRI to look at the spinal cord, doctors can identify damage here and in the brain. This is important in the diagnosis of multiple sclerosis.
Some people are at risk of being allergic to the gadolinium used in T1-weighted scans. Gadolinium may increase the risk of kidney damage in people who already have impaired kidney function.
What do the results mean?
Radiologists who specialize in image interpretation analyze the results of MRI scans. These results are referred to the individual’s physician for further interpretation.
The doctor will determine if the test results indicate multiple sclerosis or if the lesions are due to something else, such as a pre-existing stroke, migraines, or high blood pressure.
Aging can also cause small brain lesions not associated with MS, especially in people over age 50. Doctors still use MRI scans to determine if older adults have MS, but the diagnosis can be more difficult.
MRI tests are important for diagnosing MS, but they’re not the only tests doctors use because scans don’t always show MS lesions.
What is the outlook for patients with MS? Learn more about
Doctors may use tests other than radiology to diagnose MS. Among which:
Cerebrospinal fluid (CSF) test: In this test, a needle is inserted into the spinal cord to remove CSF. The presence of certain proteins in the cerebrospinal fluid may indicate that someone has multiple sclerosis.
Evoked Potential Test: An evoked potential test measures how a person’s brain responds to certain stimuli. Examples of stimuli are flashing lights or electrical pulses that the doctor applies to the patient’s leg or arm. The test helps doctors diagnose MS by determining how efficiently and quickly nerve impulses are transmitted.
RRMS may respond to a new class of drugs called disease-modifying therapies (DMTs).
DMT is designed to slow the progression of MS, including:
- beta interferon
- glatiramer acetate
- Dimethyl fumarate
Some medications are available as an injection or by mouth, while others are given by a doctor at regular intervals through an IV.
- However, these drugs are unlikely to help people with advanced MS.
- treatment of seizures and symptoms
- lifestyle choices and treatments
Multiple sclerosis is a lifelong progressive disease that can cause severe symptoms in some cases.
However, most people with MS experience mild to moderate symptoms and remain mobile. According to the National Institute of Neurological Disorders and Stroke, MS patients can expect to live as long as people without MS.