MRI-clinical correlations: more than inflammation alone-what can MRI contribute to improve the understanding of pathological processes in MS?

Magnetic resonance imaging (MRI) is a sensitive technique in the detection and follow-up of multiple sclerosis (MS) lesions. However, the pathologic basis of these changes is poorly understood. It is becoming increasingly apparent that routine MRI techniques do not represent specific histopathologic changes but reflect a variety of pathological changes in tissue. This review will outline the findings in MRI-pathology correlation in MS to date, and the current understanding of the evolution of pathologic changes in the MS lesion and non-lesional white matter as reflected by MRI. Possible future contributions of MRI to unveiling the dynamic pathology of MS will also be discussed.