Magnetic resonance imaging in the diagnosis of multiple sclerosis cerebral foci

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Abstract

The close attention to the problem of multiple sclerosis (MS) is by no means accidental. The widespread prevalence of the disease, the young age of the patients, the low effectiveness of therapy and the high percentage of disability among people of the most working age cause extreme concern [3, 7, 19]. MS is the most common demyelinating disease of the nervous system, which is characterized by a polysymptomatic and recurrent course [1, 4, 5, 59]. According to R. Detd. et al. (1977) and S.M. Poser et al. (1983), MS occurs in 4-10% of cases in different countries, more often in the south of Russia, Israel, the United States, Europe and Latin America. The pathogenesis of the disease is not fully understood, in particular, the role of genetic factors and autoimmune processes in the mechanisms of MS development has not been fully determined [2, 55, 70]. The basis of the disease is the process of demyelination with the formation of disseminated dense sclerotic foci in the white matter of the brain [31, 33]. These foci, resembling gliosis scars, are the result of a local inflammatory process, accompanied by the destruction of the myelin sheaths and axons of nerve cells [28]. The pathological feature of MS is considered to be a violation of the blood-brain barrier. In the acute phase of the disease, the disintegration of oligodendrocytes, which make up the myelin sheath of axons, and the migration of activated immune cells to the focus of antigenic conflict (into microglia and astrocytes) occur. In this case, there is “muff-like adhesion” of endothelial cells and leukocytes around venules and along the pathways with the subsequent formation of dense sclerotic plaques [8, 16]. In some cases, remyelination occurs, and then re-disintegration with the formation of plaques. In postmortem examination, MS foci are most often detected near the anterior and posterior parts of the lateral ventricles, in the region of the semi-oval center, subcortical nuclei, trunk, cerebellum, in the spinal cord, and also in the optic nerves.

About the authors

M. M. Ibatullin

Kazan State Medical University; Interregional Clinical Diagnostic Center

Email: info@eco-vector.com
Russian Federation, Kazan; Kazan

T. V. Matveeva

Kazan State Medical University; Interregional Clinical Diagnostic Center

Email: info@eco-vector.com
Russian Federation, Kazan; Kazan

A. M. Anufriev

Kazan State Medical University; Interregional Clinical Diagnostic Center

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Kazan; Kazan

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