On MRI, multiple sclerosis is characterized by cerebral plaques disseminating in space and time which are characteristic of demyelinating areas. These lesions are commonly void, and located in periventricular white matter, cerebellum, and the brain stem. These lesions are hyperintense on T2 sections of a MRI.
On T1-weighted MRI, MS lesions are isointens to white matter, but sometimes we see these lesions as a hypointens lesions called “black holes” mostly seen in supratentorial region . These black holes can disappear after several months due to remyelination but persistent black hole lesion can be a marker of active disease and demyelination injury.[8][9][10]
NOTE: To differentiate acute and chroniclesion from each other, we most know that acutelesions tends to be larger in size with poor defined border, but chroniclesion are smaller due to reduction of inflammation and edema and have sharp borders in imaging.[13]
↑Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mörk S, Bö L (January 1998). "Axonal transection in the lesions of multiple sclerosis". N. Engl. J. Med. 338 (5): 278–85. doi:10.1056/NEJM199801293380502. PMID9445407.
↑Fazekas F, Barkhof F, Filippi M, Grossman RI, Li DK, McDonald WI, McFarland HF, Paty DW, Simon JH, Wolinsky JS, Miller DH (August 1999). "The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis". Neurology. 53 (3): 448–56. PMID10449103.
↑Bakshi R, Shaikh ZA, Janardhan V (January 2000). "MRI T2 shortening ('black T2') in multiple sclerosis: frequency, location, and clinical correlation". Neuroreport. 11 (1): 15–21. PMID10683822.
↑Bakshi R, Dmochowski J, Shaikh ZA, Jacobs L (March 2001). "Gray matter T2 hypointensity is related to plaques and atrophy in the brains of multiple sclerosis patients". J. Neurol. Sci. 185 (1): 19–26. PMID11266686.
↑Lukas C, Sombekke MH, Bellenberg B, Hahn HK, Popescu V, Bendfeldt K, Radue EW, Gass A, Borgwardt SJ, Kappos L, Naegelin Y, Knol DL, Polman CH, Geurts JJ, Barkhof F, Vrenken H (November 2013). "Relevance of spinal cord abnormalities to clinical disability in multiple sclerosis: MR imaging findings in a large cohort of patients". Radiology. 269 (2): 542–52. doi:10.1148/radiol.13122566. PMID23737540.
↑Nijeholt GJ, van Walderveen MA, Castelijns JA, van Waesberghe JH, Polman C, Scheltens P, Rosier PF, Jongen PJ, Barkhof F (April 1998). "Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms". Brain. 121 ( Pt 4): 687–97. PMID9577394.
↑McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (July 2001). "Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis". Ann. Neurol. 50 (1): 121–7. PMID11456302.
↑van Walderveen MA, Kamphorst W, Scheltens P, van Waesberghe JH, Ravid R, Valk J, Polman CH, Barkhof F (May 1998). "Histopathologic correlate of hypointense lesions on T1-weighted spin-echo MRI in multiple sclerosis". Neurology. 50 (5): 1282–8. PMID9595975.
↑Simon JH, Lull J, Jacobs LD, Rudick RA, Cookfair DL, Herndon RM, Richert JR, Salazar AM, Sheeder J, Miller D, McCabe K, Serra A, Campion MK, Fischer JS, Goodkin DE, Simonian N, Lajaunie M, Wende K, Martens-Davidson A, Kinkel RP, Munschauer FE (July 2000). "A longitudinal study of T1 hypointense lesions in relapsing MS: MSCRG trial of interferon beta-1a. Multiple Sclerosis Collaborative Research Group". Neurology. 55 (2): 185–92. PMID10908888.
↑Bitsch A, Kuhlmann T, Stadelmann C, Lassmann H, Lucchinetti C, Brück W (June 2001). "A longitudinal MRI study of histopathologically defined hypointense multiple sclerosis lesions". Ann. Neurol. 49 (6): 793–6. PMID11409432.
↑Chard DT, Griffin CM, Parker GJ, Kapoor R, Thompson AJ, Miller DH (February 2002). "Brain atrophy in clinically early relapsing-remitting multiple sclerosis". Brain. 125 (Pt 2): 327–37. PMID11844733.
↑Zivadinov R, Havrdová E, Bergsland N, Tyblova M, Hagemeier J, Seidl Z, Dwyer MG, Vaneckova M, Krasensky J, Carl E, Kalincik T, Horáková D (September 2013). "Thalamic atrophy is associated with development of clinically definite multiple sclerosis". Radiology. 268 (3): 831–41. doi:10.1148/radiol.13122424. PMID23613615.
↑Ingle GT, Thompson AJ, Miller DH (2002). "Magnetic resonance imaging in primary progressive multiple sclerosis". J Rehabil Res Dev. 39 (2): 261–71. PMID12051469.