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Updated: Aug 14, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
The evolution of multiple sclerosis lesions on serial MR
1Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Purpose:
To characterize temporal changes in signal intensity patterns of multiple sclerosis lesions on serial MR.
Methods:
T1-, T2-, proton density-, and contrast-enhanced T1-weighted MR was performed on five patients with relapsing-remitting multiple sclerosis at least 22 times in the course of 1 year.
Results:
Forty-three enhancing lesions and 1 new lesion that never showed enhancement were detected and followed for periods ranging from approximately 4 weeks to 1 year (total of 702 time points). At first detection the center of new lesions was brighter than the periphery (20 of 24 new lesions on proton density-weighted and 19 of 23 new lesions on contrast-enhanced images). On contrast-enhanced images, ring hyperintensity was predominant at time points later than 29 days. As lesions aged, a residual rim of "nonenhancing" hyperintensity often was noted on contrast-enhanced images. Some older lesions (> 1 year) showed similar appearance on unenhanced T1-weighted images. On proton density-weighted images ring hyperintensity was most frequent 2 to 4 months after lesion detection. The estimated average duration of gadopentetate dimeglumine enhancement was 1 to 2 months.
Conclusions:
A lesion evolution pattern relevant to MR was inferred. We believe that specific information about the histopathologic evolution of a lesion may be extracted not only from contrast-enhanced but also from nonenhanced serial MR. Assessment of drugs targeting specific phases of lesion evolution could benefit from quantitative pattern analysis of routine MR images.
Insights
Serial MRI reveals distinct signal intensity changes in multiple sclerosis lesions over time. These patterns on enhanced and unenhanced scans offer insights into lesion evolution and potential histopathology.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
- Understanding the temporal dynamics of MS lesions is crucial for diagnosis and treatment monitoring.
Purpose of the Study:
- To characterize temporal changes in signal intensity patterns of multiple sclerosis lesions using serial magnetic resonance (MR).
- To explore the potential of non-enhanced and contrast-enhanced MR imaging in inferring lesion histopathology.
Main Methods:
- Serial T1-, T2-, proton density-, and contrast-enhanced T1-weighted MR imaging was performed.
- Five patients with relapsing-remitting MS underwent at least 22 scans over one year.
- Lesions were tracked for periods ranging from 4 weeks to 1 year.
Main Results:
- New lesions often showed central hyperintensity at initial detection.
- Ring hyperintensity on contrast-enhanced images was predominant after 29 days.
- Gadopentetate dimeglumine enhancement lasted an average of 1-2 months, with residual non-enhancing rims observed in older lesions.
Conclusions:
- A lesion evolution pattern relevant to MR imaging was inferred.
- Serial MR imaging, both enhanced and unenhanced, can provide information about lesion histopathologic evolution.
- Quantitative pattern analysis of routine MR images may aid in assessing therapies targeting specific lesion phases.
