Magnetic resonance imaging (MRI) is the gold standard imaging technique for diagnosis and monitoring of many neurological diseases. However, the application of conventional MRI in clinical routine is mainly limited to the visual detection of macroscopic tissue pathology since mixed tissue contrasts depending on hardware and protocol parameters hamper its application for the assessment of subtle or diffuse impairment of the structural tissue integrity. Multiparametric quantitative (q)MRI determines tissue parameters quantitatively, enabling the detection of microstructural processes related to tissue remodeling in aging and neurological diseases. In contrast to measuring tissue atrophy via structural imaging, multiparametric qMRI allows for investigating biologically distinct microstructural processes, which precede changes of the tissue volume. This facilitates a more comprehensive characterization of tissue alterations by revealing early impairment of the microstructural integrity and specific disease-related patterns. So far, qMRI techniques have been employed in a wide range of neurological diseases, including in particular conditions with inflammatory, cerebrovascular and neurodegenerative pathology. Numerous studies suggest that qMRI might add valuable information, including the detection of microstructural tissue damage in areas appearing normal on conventional MRI and unveiling the microstructural correlates of clinical manifestations. This review will give an overview of current qMRI techniques, the most relevant tissue parameters and potential applications in neurological diseases, such as early (differential) diagnosis, monitoring of disease progression, and evaluating effects of therapeutic interventions.

Brain Imaging Center Goethe University Frankfurt Germany

Center for Personalized Translational Epilepsy Research Consortium Goethe University Frankfurt Germany

Department of Neurology Goethe University Frankfurt Germany

Department of Neurology Heinrich Heine University Düsseldorf Düsseldorf Germany

Department of Neurology Palacký University Olomouc and University Hospital Olomouc Olomouc Czechia

Department of Neuroradiology Goethe University Frankfurt Germany

Epilepsy Center Frankfurt Rhine Main Center of Neurology and Neurosurgery University Hospital Frankfurt Germany

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