Using 7-T brain MRI Charité and MDC researchers show: Multiple sclerosis more destructive than previously thought

Using 7-T brain magnetic resonance imaging (MRI) researchers in Berlin have  shown nearly twice as much damage in the brain of patients with multiple sclerosis (MS) as with the 1.5-T MRI typically used in routine clinical diagnosis. "MS patients should therefore in the future be treated much earlier and even more consistently," recommends study director Prof. Friedemann Paul of the Cluster of Excellence NeuroCure and the Experimental and Clinical Research Center of the Charité – Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine (MDC) in Berlin-Buch (Archives of Neurology published online Feb. 20, 2012. doi:10.1001/archneurol.2011.2450)*.

Nerve fibers are like electrical cables enclosed by an insulating layer, the myelin sheath. In multiple sclerosis (MS), a chronic disease of the central nervous system, this insulating layer is attacked in several (multiple) places by inflammatory cells and partially destroyed.

As a result, scar tissue (sclerosis) forms at these sites of inflammation. The scarred locations, known as lesions, can be visualized with the help of MRI of the brain of MS patients. The number and severity of such lesions provide information as to how advanced the disease is.

In daily clinical practice, MRI instruments with a field strength of 1.5 T or 3 T are most commonly used for diagnosis. In a recent study, Tim Sinnecker and Dr. Jens Würfel from a research group of the Cluster of Excellence NeuroCure and the Experimental and Clinical Research Center (ECRC) of the Charité and the MDC (Director: Prof. Friedemann Paul) in cooperation with the Berlin Ultrahigh Field Facility (Director: Prof. Thoralf Niendorf) examined 20 MS patients using an ultrahigh-field (7-T) MRI. In the process they found almost twice as many lesions (728) compared to the conventional exam with 1.5 T (399).

"With the improved resolution of the 7-T MRI we can visualize lesions that have so far been undetectable. The structural damage caused by MS in the brains of patients seems now to be much greater than previously thought. MS patients should therefore in the future be treated much earlier and even more consistently," recommends Prof. Paul.

"Despite the advantageous diagnostic capabilities, clinical examinations with 7-T MRI instruments will probably not be routinely carried out in the near future, but will still remain limited to research,² says Würfel. ²Because of the high field strength, several contraindications are anticipated, especially for patients with prostheses, tooth implants or tattoos."