Multiple sclerosis (MS) is the most prevalent chronic inflammatory disease of the central nervous system (CNS), affecting more than two million people worldwide and characterized by the presence of multifocal inflammatory demyelinating lesions disseminated in space and in time.
MS lesions may occur in any part of the CNS where myelin exists, but lesions around the ventricles and the corpus callosum are highly suggestive.
High MRI sensitivity in the depiction of plaques in the brain and spinal cord has made this technique the most valuable para-clinical tool for the diagnosis of multiple sclerosis (MS)
Cortical grey matter lesions occur abundantly in MS across all disease courses and are correlated with clinical manifestations, therefore, adding them as diagnostic criteria improves their specificity and reduce misdiagnosis. 2017 revision the panel recommended that, cortical lesions, in addition to sub-cortical lesions can be used to fulfil MRI criteria for DIS.
3D double inversion recovery (3D-DIR) is a new MR sequence, assumed to detect more cortical lesions than conventional sequences, which can be more specific for MS diagnosis and may allow better differentiation from MS mimics.