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Multiple Sclerosis: Hyperintense Lesions in the Brain on Nonenhanced T1-weighted MR Images Evidenced as Areas of T1 Shortening¹

¹ From the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (V.J.); Department of Radiology, University at Buffalo, State University of New York, Buffalo, NY (S.S.); and Departments of Neurology and Radiology, Center for Neurological Imaging, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, HIM 730, Boston, MA 02115 (R.B.). Received July 14, 2005; revision requested September 21; revision received August 31, 2006; accepted October 5; final version accepted February 7, 2007. R.B. supported in part by research grants from the National Institutes of Health–National Institute of Neurological Disorders and Stroke (1 K23 NS42379-01), National Multiple Sclerosis Society (RG 3258A2/1, RG 3574A1), and National Science Foundation (DBI-0234895). Address correspondence to R.B. (e-mail: rbakshi{at}bwh.harvard.edu).

View larger version (95K): [in this window] [in a new window] [Download PPT slide]   Figure 1: Transverse MR images in a 50-year-old woman with RR MS. Left: Lesion (arrow) of right centrum semiovale shows uniform hyperintensity on the nonenhanced T1-weighted image (400/10) (protocol 4). Right: Lesion (arrow) also is seen on FLAIR image (repetition time msec/echo time msec/inversion time msec, 8000/150/2200).

View larger version (84K): [in this window] [in a new window] [Download PPT slide]   Figure 2: Transverse nonenhanced T1-weighted MR images (585/20) (protocol 2) in a 41-year-old man with RR MS and mild to moderate physical disability (EDSS score, 3.5). Uniformly hyperintense lesions (arrows) are seen. Lesions have corresponding hyperintensity on FLAIR images (not shown).

View larger version (80K): [in this window] [in a new window] [Download PPT slide]   Figure 3: Transverse nonenhanced T1-weighted MR images (450/19) (protocol 1) in a 40-year-old woman with SP MS and severe physical disability (EDSS score, 6.5). Significant central and cortical atrophy and hyperintense lesions characterized by rim hyperintensity (arrows) are seen. The lesions have corresponding hyperintensity on proton density–weighted MR images (not shown).

View larger version (92K): [in this window] [in a new window] [Download PPT slide]   Figure 4: Transverse nonenhanced T1-weighted MR images (400/10) (protocol 4) in a 36-year-old woman with RR MS. Hyperintense lesions with rim of hyperintensity (periventricular and centrum semiovale lesions [vertical arrow on left image and arrow on right image]) or uniform hyperintensity (frontal pole [horizontal arrow on left image]) are seen. The lesions have corresponding hyperintensity on FLAIR images (not shown).