title: Ultra-high-field imaging distinguishes MS lesions from asymptomatic white matter lesions.
abstract: OBJECTIVE
  To investigate whether multiple sclerosis (MS) and non-MS white matter brain lesions can be distinguished by their appearance on 7 T T2*-weighted MRI.
  
  
  METHODS
  This was an observational study of 28 patients with MS and 17 patients with cerebral white matter lesions who did not have MS. Subjects were imaged using 7 T T2*-weighted imaging. White matter lesions were identified and analyzed for volume, location, and perivenous appearance.
  
  
  RESULTS
  Out of 901 lesions identified in patients with MS, 80% were perivenous. In comparison, 19% of 428 lesions identified in patients without MS had a perivenous appearance. Seven-Tesla T2*-weighted MRI reliably distinguished all patients with clinically definite MS (>40% lesions appeared perivenous) from those without clinical MS (<40% lesions appeared perivenous). Perivenous lesion appearance was more predictive of MS (odds ratio [OR] 14, p < 0.001) than subcortical or periventricular lesion location (OR 4.5, p < 0.001, and OR 2.4, p = 0.009). Perivenous lesion appearance was observed with a similar frequency in patients with clinically isolated syndrome of demyelination and in early (gadolinium-enhancing) MS lesions.
  
  
  CONCLUSIONS
  Perivenous lesion location on 7 T T2*-weighted imaging is predictive of the presence of demyelination. Optimization of this imaging technique at lower magnetic resonance field strengths would offer benefit for the diagnosis of MS.
authors.affiliation: Department of Clinical Neurology, Nottingham University Hospital NHS Trust, Nottingham, NG7 2UH, UK.
authors.forename: E C
authors.initials: EC
authors.lastname: Tallantyre
authors.forename: J E
authors.initials: JE
authors.lastname: Dixon
authors.forename: I
authors.initials: I
authors.lastname: Donaldson
authors.forename: T
authors.initials: T
authors.lastname: Owens
authors.forename: P S
authors.initials: PS
authors.lastname: Morgan
authors.forename: P G
authors.initials: PG
authors.lastname: Morris
authors.forename: N
authors.initials: N
authors.lastname: Evangelou
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000378:metabolism / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult