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Disappearance of hypointense multiple sclerotic lesions on FLAIR MRI
T Takano1, N Watanabe, T Yamano
1Department of Pediatrics, Shiga University of Medical Science, Seta-Tsukinowa, Ohtsu, Japan.
Abstract:
A child is presented who displayed hypointense multiple sclerotic lesions on fluid-attenuated inversion recovery sequences by magnetic resonance imaging, with the possible pathologic tissue changes of these hypointense lesions evaluated. The magnetic resonance imaging results in this patient demonstrated the disappearance of low-signal lesions on fluid-attenuated inversion recovery in multiple sclerosis, and the improvement of this patient's condition was likely compatible with sequential magnetic resonance imaging findings. Some hypointense lesions in the supratentorial white matter that appear on fluid-attenuated inversion recovery images in multiple sclerosis patients may include reversible brain lesions, suggesting extracellular fluid collection not accompanied by axonal loss or gliosis.
Insights
Multiple sclerosis lesions appearing as dark spots on MRI may resolve over time. This suggests some lesions involve reversible fluid buildup, not permanent brain damage.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease.
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing and monitoring MS.
- Fluid-attenuated inversion recovery (FLAIR) sequences highlight MS lesions.
Observation:
- A pediatric patient presented with hypointense lesions on FLAIR MRI sequences.
- These lesions, indicative of potential pathological changes, were evaluated.
- Sequential MRI scans were performed to monitor lesion evolution.
Findings:
- The hypointense lesions observed on FLAIR MRI in this MS patient disappeared over time.
- This resolution correlated with clinical improvement.
- The findings suggest that some supratentorial white matter hypointensities in MS may represent reversible lesions.
Implications:
- These reversible lesions may be characterized by extracellular fluid collection.
- The absence of axonal loss or gliosis in these specific lesions is a key finding.
- This understanding could refine MS lesion characterization and monitoring strategies.