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Updated: Apr 19, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Susceptibility-weighted imaging helps to discriminate pediatric multiple sclerosis from acute disseminated
James E Kelly1, Soe Mar2, Gina D'Angelo3
1Department of Radiology, Washington University School of Medicine, St. Louis, Missouri.
Insights
Susceptibility-weighted imaging can help distinguish pediatric multiple sclerosis from acute disseminated encephalomyelitis. This MRI technique identifies more lesions in multiple sclerosis patients, aiding early diagnosis.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Magnetic Resonance Imaging
Background:
- Susceptibility-weighted imaging (SWI) is an advanced MRI technique.
- SWI aids in detecting lesions associated with multiple sclerosis (MS) in adults.
- Its utility in differentiating pediatric MS from acute disseminated encephalomyelitis (ADEM) is under investigation.
Purpose of the Study:
- To evaluate the effectiveness of SWI in distinguishing between pediatric multiple sclerosis and monophasic acute disseminated encephalomyelitis.
- To assess SWI's ability to identify specific lesion characteristics in children with central nervous system demyelination.
Main Methods:
- Studied 18 children with acute central nervous system demyelination and recent MRI including SWI.
- Diagnoses were confirmed using international consensus definitions.
- Compared the number and characteristics of lesions identified on fluid-attenuated inversion recovery (FLAIR) and SWI sequences between MS and ADEM groups.
Main Results:
- Ten children were diagnosed with MS and eight with ADEM.
- Twenty-two percent of FLAIR lesions were detected on SWI.
- A significantly higher percentage of FLAIR lesions were identified on SWI in the MS group (median 0.22) compared to the ADEM group (median 0.0).
Conclusions:
- Susceptibility-weighted imaging shows promise as a tool for differentiating pediatric MS from ADEM at the time of initial presentation.
- SWI may provide crucial imaging biomarkers for early and accurate diagnosis in pediatric demyelinating diseases.
Background:
Susceptibility-weighted imaging is a relatively new magnetic resonance imaging sequence that can identify lesions of multiple sclerosis in adults. This study was designed to determine if susceptibility-weighted imaging is a useful discriminator between children who develop multiple sclerosis and children with monophasic acute disseminated encephalomyelitis.
Methods:
Eighteen children who presented with acute central nervous system demyelination and had a brain magnetic resonance imaging study including susceptibility-weighted imaging within 6 months of the first clinical attack were studied. Final diagnosis was based on international consensus definitions. Brain lesions detected on the fluid-attenuated inversion recovery sequence were assessed for abnormal signal on susceptibility-weighted imaging. The burden of susceptibility abnormalities was then analyzed for differences between the multiple sclerosis and acute disseminated encephalomyelitis groups.
Results:
Eight patients had a final diagnosis of acute disseminated encephalomyelitis and ten had multiple sclerosis. Twenty-two percent of fluid-attenuated inversion recovery lesions were identified on susceptibility-weighted imaging. The percentage of fluid-attenuated inversion recovery lesions identified on susceptibility-weighted imaging differed between the multiple sclerosis and acute disseminated encephalomyelitis groups (P = 0.04). The median percentage (minimum-maximum) of lesions identified on susceptibility-weighted imaging in the multiple sclerosis group was 0.22 (0-0.68) and in the acute disseminated encephalomyelitis group was 0.0 (0-0.17).
Conclusion:
Susceptibility-weighted imaging may be a useful technique in differentiating acute disseminated encephalomyelitis from multiple sclerosis at initial presentation.
