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Updated: Jun 12, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
T1-based stratification of paramagnetic rim lesions in multiple sclerosis: Evidence of microstructural heterogeneity
Zhuowei Shi1, Huajiao Wang1, Zichun Yan1
1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background:
Paramagnetic rim lesions (PRLs) in multiple sclerosis (MS) exhibited intrinsic heterogeneity.
Objectives:
We aimed to assess whether T1-intensity-based stratification captures PRL heterogeneity and its clinical associations.
Methods:
This prospective study included 112 patients with MS. PRLs were classified using corresponding T1-weighted black holes (BH) into four subtypes: PRL+BH+, PRL+BH-, PRL-BH+, PRL-BH-. The diffusion kurtosis metrics, neurite density index (NDI) and subvoxel paramagnetic/diamagnetic susceptibility were analyzed among different lesion types. Generalized linear mixed-effects models were used to assess associations between PRL subtype and clinical outcomes.
Results:
PRL+BH+ exhibited lower axial/radial/mean kurtosis, NDI and diamagnetic susceptibility (all p < 0.01) than PRL+BH-. PRL+BH+ volume correlated positively with higher EDSS (β = 0.061, 95% CI: 0.033 to 0.085, q < 0.001) and with lower SDMT (β = -2.096, 95% CI: -3.196 to -0.996, q = 0.009) and brain parenchymal volume (β = -2.928, 95% CI: -5.415 to -1.553 q < 0.001). Total PRL volume was associated with higher EDSS (β = 0.054, 95% CI: 0.033 to 0.075, q < 0.001).
Conclusions:
Our finding support the utility of T1-intensity for distinguishing heterogeneity within PRLs.
Insights
T1-intensity stratification effectively distinguishes paramagnetic rim lesion (PRL) heterogeneity in multiple sclerosis (MS). This classification correlates with distinct diffusion kurtosis metrics and clinical outcomes, supporting its utility in MS research.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Paramagnetic rim lesions (PRLs) in multiple sclerosis (MS) display significant heterogeneity.
- Understanding this heterogeneity is crucial for MS pathogenesis and treatment monitoring.
Purpose of the Study:
- To determine if T1-intensity stratification can differentiate PRL heterogeneity.
- To investigate the associations between PRL subtypes and clinical outcomes in MS patients.
Main Methods:
- 112 MS patients were prospectively studied.
- PRLs were classified into four subtypes based on T1-weighted black hole (BH) presence: PRL+BH+, PRL+BH-, PRL-BH+, PRL-BH-.
- Diffusion kurtosis metrics, neurite density index (NDI), and magnetic susceptibility were analyzed. Associations with clinical outcomes (EDSS, SDMT, brain parenchymal volume) were assessed using generalized linear mixed-effects models.
Main Results:
- PRL+BH+ lesions showed significantly lower kurtosis, NDI, and diamagnetic susceptibility compared to PRL+BH-.
- PRL+BH+ volume positively correlated with higher Expanded Disability Status Scale (EDSS) scores and lower Symbol Digit Modalities Test (SDMT) scores and brain parenchymal volume.
- Total PRL volume was associated with increased EDSS scores.
Conclusions:
- T1-intensity-based stratification is a valuable tool for identifying heterogeneity within paramagnetic rim lesions in MS.
- This approach reveals distinct microstructural properties and clinical associations for different PRL subtypes.
