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Updated: May 30, 2026

Positron Emission Tomography Imaging for In Vivo Measuring of Myelin Content in the Lysolecithin Rat Model of Multiple Sclerosis
Published on: February 28, 2021
Lesions by tissue specific imaging characterize multiple sclerosis patients with more advanced disease
Francesca Bagnato1, Vasiliki N Ikonomidou, Peter van Gelderen
1National Institutes of Neurological Disorders and Stroke, Building 10, Room C103, NIH, Bethesda, MD, USA. francesca.r.bagnato@vanderbilt.edu
Background:
Cerebrospinal fluid tissue specific imaging (CSF-TSI), a newly implemented magnetic resonance imaging (MRI) technique, allows visualization of a subset of chronic black holes (cBHs) with MRI characteristics suggestive of the presence of CSF-like fluid, and representing lesions with extensive tissue destruction.
Objective:
To investigate the relationship between lesions in CSF-TSI and disease measures in patients with multiple sclerosis (MS).
Methods:
Twenty-six patients with MS were imaged at 3.0 T, obtaining T(1)-weighted (T(1)-w) and T(2)-w spin echo (SE), T(1) volumetric images and CSF-TSI images. We measured: (i) lesion volume (LV) in T(1)-w (cBH-LV) and T(2)-w SE images, and in CSF-TSI; (ii) brain parenchyma fraction (BPF). Differences between patients with and without CSF-TSI lesions were analyzed and association between clinical and MRI metrics were investigated.
Results:
cBHs were seen in 92% of the patients while lesions in CSF-TSI were seen in 40%. Patients with CSF-TSI lesions were older, with longer disease duration, higher disability scores, larger cBH-LV and T(2)-LV, and lower BPF than patients without CSF-TSI lesions (≤0.047). Partial correlation analysis correcting for T(2)-LV, cBH-LV and BPF showed an association (p < 0.0001, r = 0.753) between CSF-TSI LV and disability score.
Conclusions:
CSF-TSI lesions characterize patients with more advanced disease and probably contribute to the progress of disability.

