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Updated: Nov 30, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Longitudinal Magnetic Resonance Imaging of Cerebral Microbleeds in Multiple Sclerosis Patients
Karthikeyan Subramanian1, David Utriainen2,3, Deepa P Ramasamy4
1Department of Radiology, Wayne State University, Detroit, MI 48201, USA.
Abstract:
We hypothesized that cerebral microbleeds (CMBs) in multiple sclerosis (MS) patients will be detected with higher prevalence compared to healthy controls (HC) and that quantitative susceptibility mapping (QSM) will help remove false positives seen in susceptibility weighted imaging (SWI). A cohort of 100 relapsing remitting MS subjects scanned at 3T were used to validate a set of CMB detection guidelines specifically using QSM. A second longitudinal cohort of 112 MS and 25 HCs, also acquired at 3T, was reviewed across two time points. Both cohorts were imaged with SWI and fluid attenuated inversion recovery. Fourteen subjects in the first cohort (14%, 95% CI 8-21%) and twenty-one subjects in the second cohort (18.7%, 95% CI 11-27%) had at least one CMB. The combined information from SWI and QSM allowed us to discern stable CMBs and new CMBs from potential mimics and evaluate changes over time. The longitudinal results demonstrated that longer disease duration increased the chance to develop new CMBs. Higher age was also associated with increased CMB prevalence for MS and HC. We observed that MS subjects developed new CMBs between time points, indicating the need for longitudinal quantitative imaging of CMBs.
Insights
Cerebral microbleeds (CMBs) are more common in multiple sclerosis (MS) patients. Quantitative susceptibility mapping (QSM) aids in accurate CMB detection and monitoring disease progression over time.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Cerebral microbleeds (CMBs) are small lesions that can occur in the brain.
- Their prevalence and significance in multiple sclerosis (MS) are not fully understood.
- Susceptibility weighted imaging (SWI) is commonly used to detect CMBs, but can produce false positives.
Purpose of the Study:
- To investigate the prevalence of CMBs in MS patients compared to healthy controls (HC).
- To evaluate the utility of quantitative susceptibility mapping (QSM) in improving CMB detection accuracy.
- To assess the longitudinal changes and risk factors associated with CMB development in MS.
Main Methods:
- Two cohorts of MS patients and HCs were scanned at 3T using SWI and fluid attenuated inversion recovery (FLAIR).
- A validation cohort (n=100 MS) used QSM to refine CMB detection guidelines.
- A longitudinal cohort (n=112 MS, n=25 HC) was assessed at two time points.
Main Results:
- CMBs were detected in 14% of the validation cohort and 18.7% of the longitudinal cohort.
- Combined SWI and QSM improved the differentiation of true CMBs from mimics.
- Longer disease duration and older age were associated with an increased prevalence of new CMBs in MS patients.
Conclusions:
- MS patients exhibit a higher prevalence of CMBs compared to HC.
- QSM enhances the reliability of CMB detection and monitoring.
- Longitudinal imaging is crucial for understanding CMB development and its relationship with disease progression in MS.
