http://blizard.qmul.ac.uk/

Klaus Schmierer

& Amy McDowell

Using MRI as a research tool

MS Research Day, 21 Mar 2015

What does MRI add over and above what…

…provide

- History

- Examination

- Pathology

- Epidemiology

- Blood & spinal fluid tests

Making the diagnosis of MS

quicker and more accurate

MRI as a research tool: Example 1

“To be suggestive of MS

lesions have to be disseminated

in space and time.

And there must be no better

explanation.”Ian McDonald1933 – 2006

McDonald criteria

Swanton JK, et al. JNNP 2006

Lesions in different locations

Swanton JK, et al. JNNP 2006

Lesions developing over time

≥30 days

2010 revision of ‘McDonald’ criteria

Polman, et al. Ann Neurol 2011

MS under the microscopeThe veins in MS Lesions

Schmierer, et al. Ann Neurol 2004

The blood in

Vein scan (T2*) Lesion scan (FLAIR)

Lesions & veins

(FLAIR*)

Sati, et al. Radiology 2012

The

Central Vein

sign

o n= 25 pwRMS

o 14 men;11 women

o age 41 ± 11.2 y

o RRMS for 7 ± 5.3 y

o MRI @ 3T:

o 3D FLAIR (after Gd

injection), 3D T2

and T2*

Tom CampionMarc Miquel & Campion, et al. AAN 2015 & ASNR 2015

• 338 lesions deteced (13.5 ± 7)

• Proportion of CVS+ lesions: 88%

• All patients met MS criterion (≥45% CVS+)

• 3/25 fulfilled McDonald criteria using a single MRI head scan.

Results – FLAIR* in MS

Campion, et al. AAN 2015 & ASNR 2015

Detect CNS changes better than by recording symptoms/ examination in clinic

MRI as a research tool: Example 2

T2

“Myelin images” of the brain

Standard image “Myelin water” mapLaule 2004

Assessing normal white matter and MS lesions using “Myelin Water Fraction” MRI

Myelin imaging using “short T2”

Tobias Wood

Amy McDowell

Gareth Barker

McDowell, et al. ISMRM 2015

Acknowledgements

http://multiple-sclerosis-research.blogspot.com/