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Updated: Jun 21, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
In vivo imaging of cortical pathology in multiple sclerosis using ultra-high field MRI
Caterina Mainero1, T Benner, A Radding
1Athinoula Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA. caterina@nmr.mgh.harvard.edu
Objective:
We used ultra-high field MRI to visualize cortical lesion types described by neuropathology in 16 patients with multiple sclerosis (MS) compared with 8 age-matched controls; to characterize the contrast properties of cortical lesions including T2*, T2, T1, and phase images; and to investigate the relationship between cortical lesion types and clinical data.
Methods:
We collected, on a 7-T scanner, 2-dimensional fast low-angle shot (FLASH)-T2*-weighted spoiled gradient-echo, T2-weighted turbo spin-echo (TSE) images (0.33 x 033 x 1 mm(3)), and a 3-dimensional magnetization-prepared rapid gradient echo.
Results:
Overall, 199 cortical lesions were detected in patients on both FLASH-T2* and T2-TSE scans. Seven-tesla MRI allowed for characterization of cortical plaques into type I (leukocortical), type II (intracortical), and type III/IV (subpial extending partly or completely through the cortical width) lesions as described histopathologically. Types III and IV were the most frequent type of cortical plaques (50.2%), followed by type I (36.2%) and type II (13.6%) lesions. Each lesion type was more frequent in secondary progressive than in relapsing-remitting MS. This difference, however, was significant only for type III/IV lesions. T2*-weighted images showed the highest, while phase images showed the lowest, contrast-to-noise ratio for all cortical lesion types. In patients, the number of type III/IV lesions was associated with greater disability (p < 0.02 by Spearman test) and older age (p < 0.04 by Spearman test).
Conclusions:
Seven-tesla MRI detected different histologic cortical lesion types in our small multiple sclerosis (MS) sample, suggesting, if validated in a larger population, that it may prove a valuable tool to assess the contribution of cortical MS pathology to clinical disability.
Insights
Ultra-high field MRI visualized distinct multiple sclerosis (MS) cortical lesion types, correlating with disease severity and age. This advanced imaging may help assess MS pathology
Area of Science:
- Neuroimaging
- Magnetic Resonance Imaging (MRI)
- Neuropathology
Background:
- Multiple sclerosis (MS) involves complex brain pathology, including cortical lesions.
- Accurate visualization and characterization of MS cortical lesions are crucial for understanding disease progression and clinical impact.
Purpose of the Study:
- To utilize ultra-high field (7-Tesla) MRI to visualize and characterize histopathologically defined cortical lesion types in MS patients.
- To investigate the contrast properties of different lesion types using various MRI sequences.
- To explore the relationship between cortical lesion types and clinical data in MS.
Main Methods:
- Acquisition of 7-Tesla MRI data, including 2D FLASH-T2*-weighted and T2-weighted TSE sequences.
- Characterization of cortical lesions into types I, II, and III/IV based on neuropathological descriptions.
- Analysis of lesion frequency, contrast-to-noise ratios, and correlation with clinical data.
Main Results:
- 199 cortical lesions were detected in 16 MS patients.
- Seven-tesla MRI enabled differentiation of MS cortical lesions into types I, II, and III/IV, with types III/IV being most frequent.
- Type III/IV lesions were more prevalent in secondary progressive MS and associated with greater disability and older age.
Conclusions:
- Seven-tesla MRI successfully visualized distinct histopathological cortical lesion types in MS.
- This advanced imaging technique shows promise for assessing the contribution of cortical MS pathology to clinical disability, pending validation in larger cohorts.
