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Updated: Jul 28, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Measure of magnetization transfer in multiple sclerosis demyelinating plaques, white matter ischemic lesions, and
R C Mehta1, G B Pike, D R Enzmann
1Department of Radiology, Stanford University School of Medicine, CA 94305, USA.
Purpose:
To define the percentage of magnetization transfer of multiple sclerosis (MS) plaques, ischemic white matter lesions, and vasogenic edema to determine whether this measurement can help differentiate these entities.
Methods:
Findings were compared in 25 patients with proved MS, 20 patients with white matter ischemic lesions, and 72 patients with white matter edema (caused by tumors, infections, or acute/subacute infarctions) in the periventricular system, centrum semiovale, and subcortical white matter. Magnetization transfer was performed using an on-resonance binomial pulse. The percentage of magnetization transfer of the normal white matter was also calculated.
Results:
Magnetization transfer was significantly higher in white matter ischemic lesions (range, 31% to 38%; mean, 34% +/- 0.6%) than in demyelinating plaques of MS (range, 19% to 28%; mean, 22.5% +/- 1%) and in edema (range, 29% to 37%; mean, 30.2% +/- 0.4%). No statistical difference in percentage of magnetization transfer was found among lesions in the periventricular system (34% +/- 0.6%), centrum semiovale (35% +/- 0.5%), or subcortical white matter (33% +/- 0.6%), or in vasogenic edema associated with tumors, infections, or infarction.
Conclusion:
Differences in magnetization transfer suggest less change of demyelination in white matter ischemic lesions than in MS plaques and are significantly different in this respect from similar MS plaques. Magnetization transfer of edema was less than that of normal white matter or fell between ischemic abnormalities and MS plaques. Percentages of magnetization transfer below the mid-20% range is highly suggestive of demyelination. Vasogenic edema, our surrogate for increased water content of white matter, caused a decrease in the percentage of magnetization transfer.
Insights
Magnetization transfer (MT) percentages help differentiate white matter lesions. Ischemic lesions show higher MT than multiple sclerosis (MS) plaques, while edema has varying MT values.
Area of Science:
- Neuroimaging
- Radiology
- Biophysics
Background:
- Differentiating white matter lesions is crucial in neurological diagnostics.
- Multiple Sclerosis (MS) plaques, ischemic lesions, and vasogenic edema present challenges in accurate identification.
- Magnetization transfer (MT) is a quantitative MRI technique sensitive to tissue microstructure.
Purpose of the Study:
- To determine the percentage of magnetization transfer (MT) in multiple sclerosis (MS) plaques, ischemic white matter lesions, and vasogenic edema.
- To assess the utility of MT measurements in distinguishing between these white matter pathologies.
Main Methods:
- A comparative study involving patients with MS, ischemic white matter lesions, and vasogenic edema.
- Magnetization transfer imaging was performed using an on-resonance binomial pulse sequence.
- Percentage of magnetization transfer was calculated for lesions and normal-appearing white matter.
Main Results:
- Magnetization transfer was significantly higher in white matter ischemic lesions (mean 34%) compared to MS plaques (mean 22.5%).
- Vasogenic edema showed intermediate MT values (mean 30.2%), not statistically different across lesion locations.
- MT values below 25% strongly suggest demyelination, characteristic of MS plaques.
Conclusions:
- Magnetization transfer percentages offer a quantitative method to differentiate white matter ischemic lesions from MS plaques.
- Lower MT values are indicative of demyelination, aiding in the diagnosis of MS.
- Vasogenic edema exhibits distinct MT characteristics, differing from both ischemic lesions and MS plaques.
