Neurológia pre prax 6/2012

The importance of magnetic resonance imaging in monitoring of disease activity of multiple sclerosis – a clinical neurologist insight

There has been a notable progress in research of multiple sclerosis (MS) during the last 30 years. The most important result of this effort has been the discovery of new, more effective drugs. These drugs have on one hand brought great hope, but on the other hand they have created new demands in approaching individual treatment. The focal question is – which drugs to use? When? And for whom? The main reason for that is a high variability of the disease, which demands very thorough monitoring of the disease in individual patients. Nowadays magnetic resonance imaging is the most frequently used biomarker. It helps in a diagnostic process, prognosis, and disease monitoring. New diagnostic criteria from 2011 enable us to confirm the diagnosis of MS from the first MRI examination, which significantly shortens the time before starting treatment. After treatment has started, we recommend to continue with a quantitative MRI protocol that shows, even in a routine practice, not only quantification of lesions, but also total and regional brain atrophy which better reflects the neurodegenerative processes.

Keywords: multiple sclerosis, magnetic resonance imaging, disease activity, brain atrophy, biomarker.