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Updated: Dec 17, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
7T MPFLAIR versus MP2RAGE for Quantifying Lesion Volume in Multiple Sclerosis
Margaret Spini1, Seongjin Choi2, Daniel M Harrison2,3
1School of Medicine, University of Maryland School of Medicine, Baltimore, MD.
Background And Purpose:
Use of fluid-attenuated inversion recovery (FLAIR) scans to quantify multiple sclerosis (MS) lesion volume on 7 Tesla (7T) magnetic resonance imaging (MRI) has many downsides, including poor image homogeneity. There are little data about the relative benefit of alternative modalities. The purpose of this paper is to investigate if magnetization-prepared 2 rapid acquisition gradient echo (MP2RAGE) is a viable alternative to FLAIR for robust lesion volume measurement and disability correlations.
Methods:
Forty-seven participants with MS underwent annual brain 7T MRIs. Magnetization-prepared FLAIR (MPFLAIR) and MP2RAGE (both at .7 mm3 isotropic resolution) sequences from a total of 80 MRI scans from 47 subjects were reviewed. White matter lesion (WML) masks were manually constructed from MPFLAIR and T1 maps (from MP2RAGE). Lesion volumes (normalized to intracranial volume) were compared to clinical characteristics and disability scales scores by Pearson or Spearman correlation, as appropriate. Relative correlation strength was compared by Fisher r- to z-transformation.
Results:
Normalized lesion volume was greater in MPFLAIR masks (median .005 [range, .001-.030]) than from T1 maps (median .003 [range, .000-.015]). However, lesion volumes between MPFLAIR and T1 maps were highly correlated (rho = .87, P < .001). WML masks from both modalities correlated with most disability measures with no significant difference in the strength of correlation.
Conclusions:
7T MPFLAIR and MP2RAGE T1 map-based WML volumes are highly intercorrelated and both correlate with disability. Thus, MP2RAGE may be a viable alternative to FLAIR-based methods for WML measurement on 7T MRI in MS research.
Insights
Magnetization-prepared 2 rapid acquisition gradient echo (MP2RAGE) shows promise as an alternative to fluid-attenuated inversion recovery (FLAIR) for measuring multiple sclerosis lesions on 7T MRI. Both methods correlate with disability, suggesting MP2RAGE
Area of Science:
- Neuroimaging
- Radiology
- Multiple Sclerosis Research
Background:
- Quantifying multiple sclerosis (MS) lesion volume using fluid-attenuated inversion recovery (FLAIR) on 7 Tesla (7T) MRI is limited by poor image homogeneity.
- Limited data exists on alternative MRI modalities for robust lesion volume measurement in MS.
- Accurate lesion quantification is crucial for tracking disease progression and treatment efficacy in MS.
Purpose of the Study:
- To evaluate magnetization-prepared 2 rapid acquisition gradient echo (MP2RAGE) as a viable alternative to FLAIR for measuring white matter lesion (WML) volume on 7T MRI.
- To assess the correlation between MP2RAGE-derived lesion volumes and clinical disability measures in patients with MS.
- To compare the robustness of MP2RAGE and FLAIR for lesion volume quantification and disability correlations in MS research.
Main Methods:
- Annual brain 7T MRIs were acquired from 47 participants with MS.
- Magnetization-prepared FLAIR (MPFLAIR) and MP2RAGE sequences were analyzed from 80 MRI scans.
- White matter lesion (WML) masks were manually created from MPFLAIR and MP2RAGE T1 maps, and lesion volumes were correlated with disability scores.
Main Results:
- Normalized WML volumes were greater with MPFLAIR compared to MP2RAGE T1 maps, but the volumes were highly correlated (rho = 0.87, P < .001).
- Both MPFLAIR and MP2RAGE T1 map-derived WML volumes showed significant correlations with most clinical disability measures.
- There was no significant difference in the strength of correlation between lesion volumes from either modality and disability measures.
Conclusions:
- 7T MPFLAIR and MP2RAGE T1 map-based WML volumes are highly intercorrelated in MS patients.
- Both modalities demonstrate significant correlations with clinical disability, indicating their utility in MS research.
- MP2RAGE represents a potentially viable alternative to FLAIR for robust WML measurement on 7T MRI in MS studies.
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