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Updated: May 21, 2026

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Periventricular venous density in multiple sclerosis is inversely associated with T2 lesion count: a 7 Tesla MRI
Tim Sinnecker1, Ivan Bozin, Jan Dörr
1NeuroCure Clinical Research Center, Charité - University Medicine Berlin, Germany.
Background:
Damage to venules in multiple sclerosis was first described decades ago. Today, ultrahigh magnetic field strength T2*-weighted magnetic resonance imaging (MRI) techniques depict very small cerebral veins in vivo with great anatomical detail.
Objective:
We aimed to investigate alterations of periventricular small blood vessel appearance in relation to T2 lesion count and distribution in multiple sclerosis and clinically isolated syndrome in comparison with healthy control subjects at 7 Tesla MRI.
Methods:
We investigated 38 patients (including 16 with early multiple sclerosis and seven with clinically isolated syndrome) and 22 matched healthy controls at 7 Tesla. The protocol included T2*-weighted Fast Low Angle Shot, and T2-weighted Turbo Inversion Recovery Magnitude sequences. We quantified periventricular venous density by a novel region-of-interest-based algorithm, expressing the ratio of 'veins per region-of-interest' as well as of 'periventricular vascular area'.
Results:
Our study revealed significantly decreased venous density in multiple sclerosis patients compared with healthy controls. Venous alterations were already detectable in clinically isolated syndrome and early multiple sclerosis, although to a smaller extent. Venous density correlated inversely with periventricular and whole-brain T2 lesion count. Furthermore, we found no indication for cerebral venous congestion in multiple sclerosis.
Conclusion:
High spatially resolving anatomical T2*-weighted MRI revealed vascular alterations in early stages of multiple sclerosis, presumably as a part of widespread haemodynamic and metabolic alterations.
Insights
Decreased small blood vessel density in the brain is evident in early multiple sclerosis (MS) and clinically isolated syndrome. This finding, observed with 7 Tesla MRI, correlates with lesion load but not venous congestion.
Area of Science:
- Neuroimaging
- Vascular Biology
- Neurology
Background:
- Venular damage in multiple sclerosis (MS) has been recognized for decades.
- Ultrahigh magnetic field strength T2*-weighted magnetic resonance imaging (MRI) now allows detailed visualization of small cerebral veins in vivo.
Purpose of the Study:
- To investigate alterations in periventricular small blood vessel appearance in MS and clinically isolated syndrome (CIS) using 7 Tesla MRI.
- To compare these alterations with T2 lesion count and distribution in patients and healthy controls.
Main Methods:
- 38 patients (16 early MS, 7 CIS) and 22 healthy controls underwent 7 Tesla MRI.
- T2*-weighted Fast Low Angle Shot and T2-weighted Turbo Inversion Recovery Magnitude sequences were utilized.
- A novel region-of-interest-based algorithm quantified periventricular venous density and vascular area.
Main Results:
- Significantly decreased venous density was observed in MS patients compared to controls.
- Venous alterations were detectable, albeit to a lesser extent, in CIS and early MS.
- Venous density showed an inverse correlation with periventricular and whole-brain T2 lesion count.
- No evidence of cerebral venous congestion was found in MS patients.
Conclusions:
- High-resolution T2*-weighted MRI reveals vascular changes in early MS stages.
- These vascular alterations are likely part of broader hemodynamic and metabolic changes in MS.
Related Concept Videos
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
Magnetic Resonance Imaging
Imaging Studies VII: Vascular Imaging
Imaging Studies IV: Magnetic Resonance Imaging
Multiple Sclerosis l: Introduction

