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MRI of the brain and spinal cord in multiple sclerosis and other disorders: Technical developments and clinical applications

Thorpe, John W; (1999) MRI of the brain and spinal cord in multiple sclerosis and other disorders: Technical developments and clinical applications. Doctoral thesis (M.D), UCL (University College London). Green open access

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Abstract

Magnetic resonance imaging (MRI) has greatly advanced our knowledge of multiple sclerosis. It has proved particularly useful in diagnosis and in understanding the natural history and pathophysiology of the disease. MRI is now increasingly being used as a surrogate marker of disease activity in the context of clinical trials. Nevertheless, major limitations of the technique remain. The MRI findings in the brain are not specific. Similar appearances can be found in a variety of other conditions affecting the central nervous system, as well as with normal aging. There remains a poor correlation between lesion load on brain MRI and measures of disability. There is clearly a need for improved imaging of the brain and in particular the spinal cord: the cord is of great significance in the development of disability in MS but has proved technically more demanding to study. In the first section of this work recent advances in pulse sequence design (including fast spin echo, fast FLAIR and fast STIR) and receiver coil technology (multi-array coils) are described. In the second section, the new pulse sequences are examined in a series of comparative studies; these conclude that fast spin echo can replace conventional spin echo as the T2-weighted sequence of choice in routine diagnostic imaging. In conjunction with multi-array coils, fast spin echo allows the reliable and rapid detection of MS lesions within the spinal cord. Cross-sectional and serial studies in MS are described. The final two chapters describe the application of the new technology to the differential diagnosis of MS, investigating the role of MRI in the diagnosis of motor neuron disease and spinal arteriovenous malformations.

Type: Thesis (Doctoral)
Qualification: M.D
Title: MRI of the brain and spinal cord in multiple sclerosis and other disorders: Technical developments and clinical applications
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Health and environmental sciences; Multiple sclerosis
URI: https://discovery.ucl.ac.uk/id/eprint/10101659
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