Zerebrale und spinale Bildgebung der Multiplen Sklerose: ein Update

Mike P. Wattjes; Peter Raab

doi:10.1055/s-0043-118215

Aktuelle Neurologie, Inhaltsverzeichnis

Aktuelle Neurologie 2018; 45(01): 29-43
DOI: 10.1055/s-0043-118215

Übersicht

Zerebrale und spinale Bildgebung der Multiplen Sklerose: ein Update

Brain and Spinal Cord MRI in Multiple Sclerosis: an Update

Autor*innen

Mike P. Wattjes

¹Dept. of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands

²Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
Peter Raab

²Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover, Hannover, Deutschland

Abstract

Zusammenfassung

Die Magnetresonanztomografie spielt in der Diagnostik der Multiplen Sklerose (MS) eine entscheidende Rolle und wurde deshalb innerhalb der MS-Diagnosekriterien verankert. Insbesondere für den Ausschluss wichtiger Differenzialdiagnosen werden immer neue MRT-Marker etabliert, wie beispielsweise das sogenannte „central vein sign“. Neben der Diagnostik hat die MRT in der MS-Verlaufsbeobachtung, und hierbei insbesondere bei der Pharmakovigilanz, eine zunehmende klinische Relevanz erlangt. Dies beinhaltet nicht nur die Erfassung der Behandlungseffektivität, sondern auch die Prädiktion des Behandlungserfolges und das Sicherheitsmonitoring. Quantitative MRT-Methoden sowie der Einsatz der (Ultra-)Hochfeld-MRT bieten uns in zunehmendem Maße die Möglichkeit, die MS-Pathologie insbesondere in auf dem konventionellen MRT-Bild normal erscheinendem Gewebe zu erfassen und zu quantifizieren. Dennoch wird die Standardisierung dieser Techniken für die MS-Diagnostik und Verlaufsbeobachtung zu den großen Herausforderungen in der Zukunft zählen, um damit diese vielversprechenden Methoden in die klinische Routine zu implementieren und zu etablieren.

Abstract

Magnetic resonance imaging (MRI) plays an important role in the diagnosis of multiple sclerosis and it has been incorporated into the McDonald diagnostic criteria for MS. In particular, for the exclusion of important differential diagnosis, new MRI markers are established such as the “central vein sign”. In addition to diagnostic purposes, MS monitoring is getting increasingly important, particularly for purposes of pharmacovigilance. This includes monitoring of treatment efficacy, prediction of treatment response and safety monitoring. Quantitative MRI methods and ultra-high field MRI offer the opportunity for quantitative assessment of damage in the normal appearing brain tissue. However, the standardization of these techniques for implementation in clinical routine will be one of the major challenges in the future.

Schlüsselwörter

MRT - Multiple Sklerose - Pharmakovigilanz - Demyelinisierung

Keywords

MRI - multiple sclerosis - pharmacovigilance - demyelination

Volltext

Referenzen

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