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Updated: May 10, 2026
Multiple-mouse Neuroanatomical Magnetic Resonance Imaging
Published on: February 27, 2011
Lesion phenotyping based on magnetic susceptibility in pediatric multiple sclerosis
Vincenzo Daniele Boccia1, Giacomo Boffa1,2, Caterina Lapucci1,2
1Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
Background And Purpose:
Pediatric multiple sclerosis (MS) displays different pathological features compared to adult MS, which can be studied in vivo by assessing tissue magnetic susceptibility with 3T-MRI. We aimed to assess different white matter lesions (WMLs) phenotypes in pediatric MS patients using quantitative susceptibility mapping (QSM) and susceptibility mapping weighted imaging (SMWI) over 12 months.
Methods:
Eleven pediatric MS patients [female: 63.6%; mean ± standard deviation (SD) age and disease duration: 16.3 ± 2.2 and 2.4 ± 1.5; median (range) Expanded Disability Status Scale (EDSS) 1 (0-2)] underwent 3 Tesla-MRI exams and EDSS assessments at baseline and after 1 year. QSM and SMWI were obtained using 3-dimensional (3D)-segmented echo-planar-imaging with submillimetric spatial resolution. WMLs were classified according to their QSM appearance and SMWI was used to identify QSM hyperintensities ascribable to veins. Total brain volumes at baseline and follow-up were computed using high-resolution 3D T1-weighted images.
Results:
Mean ± SD paramagnetic rim lesions (PRLs) prevalence was 7.0% ± 9.0. Fifty-four percent (6/11) of patients exhibited at least one PRL, with one patient exhibiting ≥ 4 PRLs. All patients showed QSM-iso-/hypo-intense lesions, which represented a mean ± SD of 65.8% ± 22.7 of total WMLs. QSM-hyperintense WMLs showed a positive correlation with total brain volume reduction at follow-up (r = 0.705; p = .02). No lesion was classified as different between baseline and follow-up.
Conclusion:
Chronic compartmentalized inflammation seems to occur early in pediatric MS patients with short disease duration. A high prevalence of iso-/hypo-intense lesions was found, which could account for the higher remyelination potential in pediatric MS.
Insights
Pediatric multiple sclerosis (MS) shows distinct white matter lesions (WMLs) with early inflammation. Quantitative susceptibility mapping (QSM) revealed frequent iso-/hypo-intense lesions, suggesting potential for remyelination in pediatric MS patients.
Area of Science:
- Neuroimaging
- Neurology
- Pediatric Medicine
Background:
- Pediatric multiple sclerosis (MS) exhibits unique pathological features compared to adult MS.
- Assessing tissue magnetic susceptibility using 3 Tesla MRI (3T-MRI) offers in vivo insights into these differences.
Purpose of the Study:
- To evaluate distinct white matter lesion (WML) phenotypes in pediatric MS patients.
- To utilize quantitative susceptibility mapping (QSM) and susceptibility mapping weighted imaging (SMWI) over a 12-month period.
Main Methods:
- Eleven pediatric MS patients underwent 3T-MRI and Expanded Disability Status Scale (EDSS) assessments at baseline and 1-year follow-up.
- QSM and SMWI were acquired using 3D-segmented echo-planar imaging.
- WMLs were classified by QSM appearance, and SMWI identified QSM hyperintensities linked to veins.
Main Results:
- Paramagnetic rim lesions (PRLs) were present in 54% of patients.
- All patients displayed QSM-iso-/hypo-intense lesions, comprising a significant portion of total WMLs.
- QSM-hyperintense WMLs correlated with greater total brain volume reduction at follow-up.
Conclusions:
- Chronic compartmentalized inflammation appears early in pediatric MS patients with short disease durations.
- The high prevalence of iso-/hypo-intense lesions may indicate a greater remyelination potential in pediatric MS.
- No significant lesion changes were observed between baseline and follow-up assessments.
