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Updated: Apr 11, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo
Sheena L Dupuy1, Shahamat Tauhid1, Gloria Kim1
1Departments of Neurology, Brigham and Women's Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA, USA.
Objective:
Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS).
Background:
Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified.
Design/Methods:
In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean±SD) 3.5±2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5T MRI scanner. Images were re-sampled to axial 5mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations.
Results:
Considering the entire cohort, T1GE detected a higher lesion volume (5.90±6.21 vs. 4.17±4.84ml, p<0.0001) and higher lesion number (27.82±20.66 vs. 25.20±20.43, p<0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p<0.01). A higher lesion number by T1GE was seen only in the RR group (p<0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r=0.29, p<0.05) while T1GE (r=0.23, p=0.13) and FLAIR (r=0.24, p=0.12) did not.
Conclusion:
Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE shows more sensitivity to lesions at the expense of less pathologic specificity for tissue destruction than T1SE.
Insights
T1 gradient-echo (T1GE) MRI sequences detect more multiple sclerosis (MS) brain lesions than T1 spin-echo (T1SE) sequences. However, T1SE shows a stronger correlation with patient disability, suggesting T1GE may be less specific for tissue destruction.
Area of Science:
- Radiology
- Neuroimaging
- Multiple Sclerosis Research
Background:
- Hypointense lesions on T1SE MRI are indicators of severe demyelination and axonal loss in MS.
- The utility of T1GE in detecting these specific MS lesions remains unclear.
Purpose of the Study:
- To compare the effectiveness of T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) MRI sequences in identifying hypointense brain lesions in multiple sclerosis (MS).
Main Methods:
- Acquired cerebral T1SE, T1GE, and T2-weighted FLAIR MRI images from 45 MS patients on a 1.5T scanner.
- Resampled images to axial 5mm slices for direct comparison of lesion detectability.
- Utilized Wilcoxon signed rank tests and Spearman correlations for statistical analysis.
Main Results:
- T1GE detected significantly higher lesion volume (p<0.0001) and lesion number (p<0.05) compared to T1SE across the cohort.
- These volume differences persisted in both relapsing-remitting (RR) and secondary progressive (SP) MS patient groups.
- T1SE showed a significant correlation with Expanded Disability Status Scale (EDSS) scores (r=0.29, p<0.05), unlike T1GE and FLAIR.
Conclusions:
- T1SE and T1GE sequences are not interchangeable for detecting hypointense lesions in MS.
- T1GE may offer increased sensitivity for lesion detection but potentially at the cost of reduced specificity for pathological tissue destruction compared to T1SE.
