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New frontiers of MR-based techniques in multiple sclerosis
  1. P Matthews

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    Edited by Massimo Filippi and Giancarlo Comi. Published by Springer-Verlag, Italy, 2003, pp 107, €49.95. ISBN 88-470-0198-6

    Magnetic resonance (MR) is the single most important laboratory technique for diagnosis and monitoring of patients with multiple sclerosis (MS). Although some may cringe at the thought of yet another review of MR methods, development of new MR based methodologies continues. This short book provides a succinct description of the “cutting edge” of the field in seven chapters written by acknowledged experts.

    Dousset, for example, describes ways in which individual cells may be tracked in the central nervous system after labelling with new iron oxide based contrast agents. Filippi, Rocca, and Rovaris review applications of both magnetisation transfer and diffusion weighted MRI to defining early axonal injury in normal appearing areas of a white matter. There is a further discussion of methods of diffusion tractography, which allows axonal tracts to be mapped, giving both information on the anatomy of major tracts and their integrity. Rashid and Miller describe applications of arterial spin-labelling magnetic resonance, a technique for defining perfusion changes that potentially provide an absolute measure of brain activity. The importance of better understanding cortical functional changes is emphasised in a nice review of functional MRI demonstrating ways in which the organisation of brain systems may change adaptively with the progression of pathology in MS. Part of the future of MRI clearly lies in enhancing sensitivity and spatial resolution of the imaging. An exciting approach to this has been development of ultra-high (>5 T) field magnets. Kangarlu and his colleagues present images of human brain from an 8 Tesla (that is more than 5 times as powerful as a conventional clinical scanner) imaging system with individual plaques of MS shown.

    This volume can be read quickly and the chapters are well written. It is highly recommended for neuroscientists and radiologists who want a brief, authoritative introduction to the current state of the art.