Multiple sclerosis and related disorders

Abstract Magnetic resonance imaging (MRI) has become an established tool for the diagnosis of multiple sclerosis (MS) and to monitor its evolution. MRI has been formally included in the diagnostic work-up of patients at presentation with clinically-isolated syndromes suggestive of MS. In patients with definite MS, the ability of MR measures in explaining clinical status and progression of disability is still suboptimal. This has prompted the application of modern MR-based technologies to estimate overall MS burden, which has allowed grading the heterogeneity of MS pathology, in focal lesions, normal-appearing white and gray matter. Combined with the use of functional imaging techniques, this is ameliorating our understanding of the factors associated with MS evolution. In the near future, MRI could significantly benefit from the use of ultra-high field systems. The utility of these MR techniques in clinical trial monitoring and in assessing individual patients’ response to treatment still need to be assessed.