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Updated: Jul 1, 2026
Registered Bioimaging of Nanomaterials for Diagnostic and Therapeutic Monitoring
Published on: December 10, 2010
Stereotactic co-registration of magnetic resonance imaging and histopathology in post-mortem multiple sclerosis brain
K Schmierer1, F Scaravilli, G J Barker
1Department of Neuroinflammation, MS NMR Research Unit, Division of Neuropathology, Institute of Neurology, University College London, London, UK.
Abstract:
A number of groups have examined the pathological substrate of signal changes on magnetic resonance imaging (MRI) in post-mortem (PM) brain of patients with multiple sclerosis (MS). Such studies will benefit from using a standardized method to reliably co-register regions of interest on MRI and tissue specimens. We investigated the usefulness of a stereotactic navigation system for this purpose. We also addressed the sensitivity of different standard MRI sequences with regard to lesion conspicuity in PM MS brain. Post-mortem brains of eight patients with MS were studied. Formalin-fixed coronal slices were placed in the head frame of a stereotactic system. Proton density-, T2-weighted and fast fluid-attenuated inversion recovery (FLAIR) scans were obtained and visually matched with scans that had been previously obtained on the same, but fresh, specimens. Guided by the stereotactic target points, the dissection of the fixed specimens was performed. After processing the blocks for embedding in paraffin, sections were stained with haematoxylin-eosin and Luxol fast blue. T2-weighted MRI of fixed brain revealed 24 areas suspected to be MS lesions, all of which were confirmed histologically. Three of these lesions were not visible on macroscopic inspection. There were 14 additional hyperintensities on T2-weighted or FLAIR MRI of the fresh specimens, five of which did not correlate to MS lesions histologically. Stereotactic navigation is a useful approach to co-register MRI and histopathology in PM brain of MS patients and may improve the precision of MRI-guided sampling of tissue specimens. Standard T2-weighted MRI appeared to be the single most useful approach for lesion detection in fresh and fixed specimens.
Insights
Stereotactic navigation aids in precisely aligning magnetic resonance imaging (MRI) with tissue samples for multiple sclerosis (MS) brain studies. Standard T2-weighted MRI is most effective for detecting MS lesions in post-mortem brain specimens.
Area of Science:
- Neuroimaging
- Neuropathology
- Multiple Sclerosis Research
Background:
- Accurate correlation between magnetic resonance imaging (MRI) signal changes and pathological findings is crucial for understanding multiple sclerosis (MS).
- Standardized methods for co-registering post-mortem (PM) MRI and tissue specimens are needed to improve reliability in MS neuropathology studies.
Purpose of the Study:
- To evaluate the utility of a stereotactic navigation system for co-registering MRI and histopathology in post-mortem MS brains.
- To assess the sensitivity of different standard MRI sequences for detecting MS lesions in post-mortem brain tissue.
Main Methods:
- Eight post-mortem MS brains were studied using a stereotactic navigation system.
- Formalin-fixed brain slices were scanned using proton density, T2-weighted, and FLAIR sequences and compared with fresh specimen scans.
- Stereotactic targeting guided dissection of fixed specimens for histological analysis (H&E, LFB staining).
Main Results:
- T2-weighted MRI of fixed brains identified 24 suspected MS lesions, all histologically confirmed.
- Three confirmed MS lesions were not visible macroscopically.
- T2-weighted MRI of fresh and fixed specimens proved most effective for lesion detection.
Conclusions:
- Stereotactic navigation facilitates precise co-registration of MRI and histopathology in post-mortem MS brain.
- This method enhances the accuracy of MRI-guided tissue sampling for MS research.
- Standard T2-weighted MRI is the optimal sequence for identifying MS lesions in post-mortem brain specimens.
