Demyelinating Diseases of the CNS (Brain and Spine)

Multiple sclerosis (MS) is the most important inflammatory demyelinating disorder that affects both the brain and spine. Dissemination in space and time on MRI is not limited to MS and can occur in neuromyelitis optica spectrum disorder (NMOSD) with aquaporin 4 antibodies, myelin oligodendrocyte glycoprotein-related antibody disease (MOGAD), and a series of other (inflammatory) demyelinating disorders. Spinal cord imaging is an important element of MS (differential) diagnosis and especially relevant in case of possible age-related vasculo-ischemic brain white matter lesions; a negative scan will help to rule out MS. Increasingly, MRI is used to monitor treatment and their complications such as progressive multifocal leukoencephalopathy (PML).