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Updated: Mar 30, 2026

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
7T MRI in natalizumab-associated PML and ongoing MS disease activity: A case study
Tim Sinnecker1, Jalal Othman1, Marc Kühl1
1Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
Objective:
To assess the ability of ultra-high-field MRI to distinguish early progressive multifocal leukoencephalopathy (PML) from multiple sclerosis (MS) lesions in a rare case of simultaneous presentation of natalizumab-associated PML and ongoing MS activity.
Methods:
Advanced neuroimaging including 1.5T, 3T, and 7T MRI with a spatial resolution of up to 0.08 mm(3) was performed.
Results:
7T MRI differentiated between PML-related and MS-related brain damage in vivo. Ring-enhancing MS plaques displayed a central vein, whereas confluent PML lesions were preceded by punctate or milky way-like T2 lesions.
Conclusions:
Given the importance of early diagnosis of treatment-associated PML, future systematic studies are warranted to assess the value of highly resolving MRI in differentiating between early PML- and MS-induced brain parenchymal lesions.

