This review highlights the potential of newer MR techniques to better reflect the pathological mechanisms of disease progression in multiple sclerosis compared to traditional T2 lesion load.
Newer MR techniques may better reflect MS progression than T2 lesions; leaves open prospective validation before clinical adoption.
Disease progression and irreversible disability in multiple sclerosis results from incomplete recovery from relapses, but most importantly from insidious disease progression. Although magnetic resonance imaging parameters, such as new lesion rate and gadolinium enhancement, reflect inflammation and disease activity they have no bearing on disease progression. Until now the T2 lesion load or disease burden has been relied upon for this, despite its poor relationship with disability measures. This paper looks at the mechanisms responsible for disease progression and discusses the MR techniques now available to reflect these pathological processes.
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Stevenson et al. (1999) studied this question.
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