Advanced Diffusion MR Imaging for Multiple Sclerosis in the Brain and Spinal Cord

Magn Reson Med Sci. 2022 Mar 1;21(1):58-70. doi: 10.2463/mrms.rev.2021-0091. Epub 2022 Feb 15.


Diffusion tensor imaging (DTI) has been established its usefulness in evaluating normal-appearing white matter (NAWM) and other lesions that are difficult to evaluate with routine clinical MRI in the evaluation of the brain and spinal cord lesions in multiple sclerosis (MS), a demyelinating disease. With the recent advances in the software and hardware of MRI systems, increasingly complex and sophisticated MRI and analysis methods, such as q-space imaging, diffusional kurtosis imaging, neurite orientation dispersion and density imaging, white matter tract integrity, and multiple diffusion encoding, referred to as advanced diffusion MRI, have been proposed. These are capable of capturing in vivo microstructural changes in the brain and spinal cord in normal and pathological states in greater detail than DTI.This paper reviews the current status of recent advanced diffusion MRI for assessing MS in vivo as part of an issue celebrating two decades of magnetic resonance in medical sciences (MRMS), an official journal of the Japanese Society of Magnetic Resonance in Medicine.

Keywords: diffusional kurtosis imaging; double diffusion encoding; multiple sclerosis; neurite orientation dispersion and density imaging; oscillating gradient spin-echo.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Diffusion Magnetic Resonance Imaging / methods
  • Diffusion Tensor Imaging / methods
  • Humans
  • Magnetic Resonance Imaging
  • Multiple Sclerosis* / diagnostic imaging
  • Multiple Sclerosis* / pathology
  • Spinal Cord / diagnostic imaging
  • White Matter* / diagnostic imaging
  • White Matter* / pathology

Grants and funding

This work was supported by JSPS KAKENHI grant numbers 19K08161, 19K17150, 18H02772, and JP16H06280, and AMED grant number JP19lk1010025h9902, the Canada Research Chair in Quantitative Magnetic Resonance Imaging [950-230815], the Canadian Institute of Health Research [CIHR FDN-143263], the Canada Foundation for Innovation [32454, 34824], the Fonds de Recherche du Québec - Santé [28826], the Natural Sciences and Engineering Research Council of Canada [RGPIN-2019-07244], Canada First Research Excellence Fund (IVADO and TransMedTech), the Courtois NeuroMod project, and the Quebec BioImaging Network [5886, 35450].