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Magnetic Resonance Imaging

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device in clinical use by the early 1980s. The early MRI...

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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla

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Paramagnetic Rim Lesions in Pediatric Multiple Sclerosis and Their Association With Brain Tissue Atrophy.

Riccardo Nistri^1,2, Ermelinda De Meo¹, Nee Na Kim^1,2

¹Queen Square MS Center, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, United Kingdom.

Neurology(R) Neuroimmunology & Neuroinflammation

|November 3, 2025

Summary

Paramagnetic rim lesions (PRLs) are common in pediatric multiple sclerosis (MS), indicating active inflammation. Higher PRL counts correlate with increased lesion burden and gray matter atrophy in children with MS.

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Area of Science:

Neuroimaging
Pediatric Neurology
Inflammatory Diseases

Background:

Paramagnetic rim lesions (PRLs) on susceptibility-based imaging (SbI) signify chronic active inflammation in multiple sclerosis (MS).
In adult MS, PRLs are linked to a more aggressive disease course.
The prevalence and significance of PRLs in pediatric MS remain less understood.

Purpose of the Study:

To determine the prevalence of PRLs in children diagnosed with MS.
To investigate the association between baseline PRL count and clinical disability.
To examine the relationship between baseline PRL count and brain tissue volume loss, both cross-sectionally and over short-term follow-up.

Main Methods:

Retrospective analysis of pediatric MS patients from UK neuroimmunology centers.
MRI data including SbI were analyzed to identify and classify PRLs.
Brain volumes were segmented, and associations with PRL burden, clinical variables, and longitudinal changes were assessed using regression models.

Main Results:

74.1% of pediatric MS patients had at least one PRL, with a median of 2.
Higher PRL counts were associated with greater T2-hyperintense lesion burden.
Increased PRL count correlated with lower gray matter volume z-scores and predicted greater deep gray matter volume loss over 17 months.

Conclusions:

PRLs are prevalent in pediatric MS and indicate significant brain tissue damage, including gray matter atrophy.
PRLs may serve as valuable imaging biomarkers for disease severity in pediatric MS.
Further long-term studies are needed to confirm the predictive ability of PRLs for future disability in pediatric MS.