Early imaging investigations in multiple sclerosis (MS) described focal sig
ns. Technological progress now suggests this concept should be revisited as
more diffuse anomalies of the central nervous system are described, someti
mes involving regions that appear normal with conventional imaging techniqu
es, This integrative concept results largely from the contribution of magne
tic resonance imaging techniques recently broadened to in vivo investigatio
ns. Technical developments in MRI now provide new contrast images (magnetiz
ation transfer, diffusion, anisotropic diffusion, functional MRI using the
BOLD method) as well as new variants of conventional sequences designed to
demonstrate specific aspects of the MS lesions: FLAIR sequence (a T2-weight
ed sequence), black holes (a particular aspect on T1-weighted images), cord
atrophy (quantification of the axial section of the cord on T1-weighted se
quences). Together these new methods should improve diagnostic sensitivity
(FLAIR) or provide prognosis information not provided by conventional seque
nces (T2 or T2 weighted images with or without gadolinium injection).