Related Experiment Video
Updated: Aug 3, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Rim lesions are demonstrated in early relapsing-remitting multiple sclerosis using 3 T-based susceptibility-weighted
Koy Chong Ng Kee Kwong1, Daisy Mollison1, Rozanna Meijboom1
1Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh bioQuarter, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
Purpose:
Rim lesions, characterised by a paramagnetic rim on susceptibility-based MRI, have been suggested to reflect chronic inflammatory demyelination in multiple sclerosis (MS) patients. Here, we assess, through susceptibility-weighted imaging (SWI), the prevalence, longitudinal volume evolution and clinical associations of rim lesions in subjects with early relapsing-remitting MS (RRMS).
Methods:
Subjects (n = 44) with recently diagnosed RRMS underwent 3 T MRI at baseline (M0) and 1 year (M12) as part of a multi-centre study. SWI was acquired at M12 using a 3D segmented gradient-echo echo-planar imaging sequence. Rim lesions identified on SWI were manually segmented on FLAIR images at both time points for volumetric analysis.
Results:
Twelve subjects (27%) had at least one rim lesion at M12. A linear mixed-effects model, with 'subject' as a random factor, revealed mixed evidence for the difference in longitudinal volume change between rim lesions and non-rim lesions (p = 0.0350 and p = 0.0556 for subjects with and without rim lesions, respectively). All 25 rim lesions identified showed T1-weighted hypointense signal. Subjects with and without rim lesions did not differ significantly with respect to age, disease duration or clinical measures of disability (p > 0.05).
Conclusion:
We demonstrate that rim lesions are detectable in early-stage RRMS on 3 T MRI across multiple centres, although their relationship to lesion enlargement is equivocal in this small cohort. Identification of SWI rims was subjective. Agreed criteria for defining rim lesions and their further validation as a biomarker of chronic inflammation are required for translation of SWI into routine MS clinical practice.
Insights
Rim lesions, indicators of chronic inflammation in multiple sclerosis (MS), were detected using susceptibility-weighted imaging (SWI) in early relapsing-remitting MS (RRMS) patients. Their association with lesion enlargement requires further investigation.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Rim lesions on MRI may indicate chronic inflammatory demyelination in multiple sclerosis (MS).
- Susceptibility-weighted imaging (SWI) offers a method to visualize these potential markers.
Purpose of the Study:
- To assess the prevalence and longitudinal volume evolution of rim lesions in early relapsing-remitting MS (RRMS) using SWI.
- To explore the clinical associations of these rim lesions.
Main Methods:
- 44 subjects with early RRMS underwent 3T MRI at baseline and 1 year.
- SWI was acquired at 1 year; rim lesions were segmented on FLAIR images for volumetric analysis.
Main Results:
- 27% of subjects had at least one rim lesion at 1 year.
- Evidence for longitudinal volume change difference between rim and non-rim lesions was mixed.
- Rim lesions showed T1 hypointense signal; no significant clinical differences were found between subjects with and without rim lesions.
Conclusions:
- Rim lesions are detectable in early RRMS using 3T MRI across multiple centers.
- The relationship between rim lesions and lesion enlargement is equivocal in this cohort.
- Standardized criteria are needed for rim lesion definition and validation as a biomarker for chronic inflammation in MS.
