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Updated: Dec 16, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Sex-specific differences in rim appearance of multiple sclerosis lesions on quantitative susceptibility mapping
Tolaymat B1, Zheng W2, Chen H1
1University of Maryland School of Medicine, Baltimore, MD, United States.
Background:
Susceptibility MRI techniques, such as phase and quantitative susceptibility mapping (QSM) reveal lesion heterogeneity in MS, including the presence of lesions with outer rims suggestive of iron accumulation in macrophages and microglia, indicative of chronic-active inflammatory white matter lesions (WMLs).
Objective:
To evaluate the in vivo relationship between chronic-active WMLs (as visualized by rimmed lesions on QSM) and several clinical metrics.
Methods:
39 patients (15 men, 24 women) with MS underwent 7 Tesla brain MRIs and clinical evaluation. Contrast patterns of lesions identified on FLAIR and quantitative susceptibility maps were reviewed and compared to demographic characteristics and disability scores.
Results:
1279 lesions were identified on FLAIR MRI; 846 (66.2%) of these were visible on QSM, 119 (14.1%) of which had visible rims. Lesions visible on QSM were more likely to have rims in men (16.1%, vs 4.9% in women, p=0.009). In a logistic regression model accounting for several factors, male sex conferred a >10-fold risk of having ≥1 rimmed lesion(s) (p=0.026).
Conclusion:
Our findings provide in vivo support for the body of histopathologic literature indicating sex-specific differences in MS WML formation and suggest that QSM can be used to study these sex differences in the future.
Insights
Quantitative susceptibility mapping (QSM) reveals that men with multiple sclerosis (MS) have a higher prevalence of chronic-active white matter lesions (WMLs) with iron-containing rims compared to women. This suggests sex-specific differences in MS lesion development.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Susceptibility MRI techniques like quantitative susceptibility mapping (QSM) identify lesion heterogeneity in multiple sclerosis (MS).
- Rimmed lesions on QSM suggest chronic-active white matter lesions (WMLs) with iron accumulation in macrophages and microglia.
- These findings are crucial for understanding MS pathogenesis and progression.
Purpose of the Study:
- To investigate the in vivo relationship between chronic-active WMLs, identified as rimmed lesions on QSM, and clinical metrics in MS patients.
- To explore potential sex-specific differences in the characteristics of these lesions.
Main Methods:
- 39 patients with MS underwent 7 Tesla brain MRI and clinical evaluations.
- Lesion contrast patterns on FLAIR and QSM were analyzed.
- Data were compared with demographic characteristics and disability scores.
Main Results:
- Of 1279 lesions on FLAIR, 846 were visible on QSM, with 119 exhibiting rims.
- Rimmed lesions were significantly more prevalent in men (16.1%) than women (4.9%) (p=0.009).
- Male sex was associated with a >10-fold increased risk of having rimmed lesions (p=0.026).
Conclusions:
- Findings support sex-specific differences in MS WML formation.
- QSM is a valuable tool for studying these sex differences in vivo.
- Further research can elucidate the clinical implications of these sex-specific differences.
