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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
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Quantitative susceptibility mapping is more sensitive and specific than phase imaging in detecting chronic active
Kelly M Gillen1, Thanh D Nguyen1, Alexey Dimov1
1Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA.
Brain Communications
|February 7, 2025
Summary
Quantitative susceptibility mapping (QSM) reliably detects iron-positive rims in multiple sclerosis lesions, unlike phase imaging. This finding is crucial for understanding lesion progression and disease severity in multiple sclerosis patients.
Area of Science:
- Neuroimaging
- Neuropathology
- Magnetic Resonance Imaging (MRI)
Background:
- Multiple sclerosis (MS) lesions with paramagnetic rims are linked to disease progression and clinical outcomes.
- Both iron and demyelination influence QSM and phase imaging signals in MS lesions.
- Pathological validation is essential to confirm the accuracy of imaging techniques in identifying iron-positive lesions.
Purpose of the Study:
- To compare the accuracy of quantitative susceptibility mapping (QSM) and phase imaging in detecting iron-positive paramagnetic rims in MS lesions.
- To validate imaging findings with histological assessment using Perls' stain as the gold standard.
Main Methods:
- Post-mortem MRI was performed on 15 MS brain slabs.
- 32 MS lesions were analyzed histologically for myelin, iron, and microglial markers.
- Three expert readers classified lesions as rim-positive or negative on QSM and phase imaging.
Main Results:
- All 10 QSM-positive lesions showed iron-positive rims histologically (100% positive predictive value).
- Only 10 of 16 phase-positive lesions had iron-positive rims (63% positive predictive value).
- QSM demonstrated a higher positive predictive value (100% vs. 63%) and comparable negative predictive value (95% vs. 94%) to phase imaging.
Conclusions:
- Quantitative susceptibility mapping is a more accurate and reliable method than phase imaging for identifying iron-positive paramagnetic rims in multiple sclerosis lesions.
- Accurate detection of iron-positive rims using QSM can improve the understanding of MS lesion evolution and its association with disease progression.
