Improved Visualization of Cortical Lesions in Multiple Sclerosis Using 7T MP2RAGE

Area of Science:

• Neuroimaging
• Radiology
• Neurology

Background:

• Cortical lesions are prevalent in multiple sclerosis (MS) but challenging to detect with conventional MRI.
• This limitation hinders understanding of their clinical significance and treatment response.

Purpose of the Study:

• To evaluate the efficacy of magnetization prepared 2 rapid acquisition gradient echoes (MP2RAGE) for visualizing cortical lesions compared to T2*-weighted imaging at 7 Tesla (7T).

Main Methods:

• Brain MRI was performed on 13 MS patients and 5 controls using 7T scanners.
• Sequences included T1-weighted MP2RAGE (500-microm isotropic resolution), T2*-weighted gradient-echo, and T2*-weighted echo-planar imaging.
• Postmortem analysis with immunohistochemistry was conducted on one case.

Main Results:

• MP2RAGE detected significantly more cortical lesions (203) than T2* gradient-echo (92) or T2* EPI (81) (P < .001).
• Forty-three percent of cortical lesions were exclusively identified by MP2RAGE across juxtacortical, leukocortical, and intracortical types.
• White matter lesion volume correlated with juxtacortical and leukocortical lesions, but not intracortical ones.

Conclusions:

• Combining MP2RAGE and T2*-weighted imaging at 7T enhances cortical lesion detection in MS.
• This improved visualization is crucial for future longitudinal studies on lesion dynamics and clinical impact.