title: Characterization of multiple sclerosis plaques using susceptibility-weighted imaging at 1.5 T: can perivenular localization improve specificity of imaging criteria?
abstract: OBJECTIVE
  The purpose of this study was to determine if magnetic resonance (MR) susceptibility-weighted imaging (SWI) can increase the conspicuity of corticomedullary veins within the white matter lesions of multiple sclerosis (MS) and, thus, aid in distinguishing plaques from leukoaraiosis.
  
  
  METHODS
  We retrospectively reviewed MR examinations in 21 patients with a clinical diagnosis of MS and 18 patients with a clinical diagnosis of dementia. Examinations included fluid-attenuated inversion recovery (FLAIR) and SWI sequences obtained in the axial plane. Lesions greater than 5 mm in diameter on the axial FLAIR sequence were identified as periventricular or subcortical. Three neuroradiologists evaluated SWI images, compared with FLAIR, for a centrally located signal void in each lesion that was scored as present, absent, or indeterminate.
  
  
  RESULTS
  In patients with MS, central veins were present in both periventricular lesions (75%, P < 0.001) and subcortical lesions (52%, P < 0.005). In patients with dementia, central veins were seen much less frequently in subcortical lesions (14%, P < 0.001); their association with periventricular lesions was not significant.
  
  
  CONCLUSIONS
  Central veins were detected in MS lesions with a significantly greater frequency than that in patients with dementia. Susceptibility-weighted imaging increases the conspicuity of corticomedullary veins and may improve the specificity of MR findings in MS.
authors.affiliation: From the *Department of Radiology, Mayo Clinic, Rochester, MN and †Siemens Medical Solutions Inc, Salt Lake City, UT.
authors.forename: John I
authors.initials: JI
authors.lastname: Lane
authors.forename: Bradley
authors.initials: B
authors.lastname: Bolster
authors.forename: Norbert G
authors.initials: NG
authors.lastname: Campeau
authors.forename: Kirk M
authors.initials: KM
authors.lastname: Welker
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gilbertson
mesh_terms: D000368:Aged; D002550:Cerebral Veins / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000473:pathology*; D003704:Dementia / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D066127:White Matter / Q000473:pathology*