Diffusion Tensor MRI in Multiple Sclerosis

Abstract Due to its increased pathologic specificity over conventional magnetic resonance imaging (MRI), diffusion tensor (DT) MR imaging is widely applied to detect and quantify multiple sclerosis (MS)-related tissue damage within T2-visible lesions as well as in the normal-appearing white and gray matter. DT MR imaging has been shown to be sensitive to the evolution of MS damage over time and to provide in vivo correlates of MS clinical severity and paraclinical markers of long-term disease evolution. Recent developments of DT MR imaging postprocessing techniques, such as tractography and voxelwise analysis, are likely to improve our understanding of the mechanisms associated with the accumulation of disability in MS. Important issues remain to be addressed, such as a detailed definition of the pathologic features underlying diffusion changes in MS and the potential of the technique in the differential diagnosis of MS.