Improved differentiation between MS and vascular brain lesions using FLAIR* at 7 Tesla

This study from Amsterdam looked at a new MRI technique called T2*-weighted fluid attenuated inversion recovery (FLAIR*) at 7 Tesla (7T). They investigated if this technique can help differentiate between MS and vascular brain lesions in 16 MS patients and 16 age-matched patients with risk factors for vascular disease.  The 3D-FLAIR and T2*-weighted images were combined to produce a single FLAIR* image and the images were analysed for lesion type and intensity, perivascular orientation and the presence of a hypointense rim.

The results showed that 74% of lesions in MS patients were more likely to be orientated in a perivascular manner, versus 47% in vascular lesions. 2.3% of MS lesions were surrounded by a hypointense rim on FLAIR* and 5.5% of MS lesions were hypointense on T2*, while no lesions in the vascular patients showed a rim or hypointensity. When a central vessel was taken into consideration, this increased the specificity from 63% to 88%, for differentiating MS lesions from vascular lesions.

Therefore, 7T FLAIR* help to differentiate MS lesions from vascular lesions when looking at lesion location, perivascular orientation and the presence of a hypointense rim around the lesion.

Authors: Kilsdonk ID, Wattjes MP
Eur Radiol. 2013 Dec 9. [Epub ahead of print]
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