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Spinal Cord in Multiple Sclerosis: MR Imaging Features and Differential Diagnosis

Alex Rovira, Cristina Auger

Seminars in Ultrasound, CT and MRI, Available online 6 May 2016

Introduction


Multiple sclerosis (MS) is a progressive inflammatory, demyelinating, and neurodegenerative autoimmune disease of the central nervous system (CNS) characterized pathologically by perivascular infiltrates of mononuclear inflammatory cells, demyelination, axonal loss, and gliosis with formation of focal and diffuse abnormalities. The optic nerves, brainstem, spinal cord, and cerebellar and periventricular white matter regions are most commonly affected, although cortical and subcortical gray matter damage is also prominent. MS leads to chronic progressive disability in most individuals with this condition.


MS affects more than 2.5 million people worldwide. The onset usually occurs between the age of 20 and 40 years, and women are affected 3-fold more often than men. MS is the leading cause of nontraumatic disability in young adults at the peak of their productive life, involved in building their career, social status, and family. As a consequence, it is associated with a tremendous loss of health-related quality of life, work productivity, and employment, not only of the patients but also of their caregivers.


The high sensitivity of magnetic resonance imaging (MRI) in depicting brain and spinal cord demyelinating plaques has made this technique the most important paraclinical tool in current use for diagnosing MS, understanding the natural history of the disease, and monitoring and predicting the efficacy of disease-modifying treatments. Spinal cord MRI is not performed as commonly as brain MRI in MS, mainly because of certain technical difficulties and the increase in total acquisition time, but the spinal cord findings can be of value for establishing an early and accurate diagnosis of the disease, imparting prognostic information, and in some cases, providing valuable data for monitoring treatment response.

 


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About the Editors

  • Prof Timothy Vartanian

    Timothy Vartanian, Professor at the Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, Cornell...
  • Dr Claire S. Riley

    Claire S. Riley, MD is an assistant attending neurologist and assistant professor of neurology in the Neurological Institute, Columbia University,...
  • Dr Rebecca Farber

    Rebecca Farber, MD is an attending neurologist and assistant professor of neurology at the Neurological Institute, Columbia University, in New...

This online Resource Centre has been made possible by a donation from EMD Serono, Inc., a business of Merck KGaA, Darmstadt, Germany.

Note that EMD Serono, Inc., has no editorial control or influence over the content of this Resource Centre. The Resource Centre and all content therein are subject to an independent editorial review.

The Grant for Multiple Sclerosis Innovation
supports promising translational research projects by academic researchers to improve understanding of multiple sclerosis (MS) for the ultimate benefit of patients.  For full information and application details, please click here

Journal Editor's choice

Recommended by Prof. Brenda Banwell

Causes of death among persons with multiple sclerosis

Gary R. Cutter, Jeffrey Zimmerman, Amber R. Salter, et al.

Multiple Sclerosis and Related Disorders, September 2015, Vol 4 Issue 5