Cerebral Cortical Lesions in Multiple Sclerosis Detected by MR Imaging at 8 Tesla
A. Kangarlua,
E.C. Bourekasa,c,
A. Ray-Chaudhuryb and
K.W. Rammohanc
a Department of Radiology, The Ohio State University College of Medicine, Columbus, Ohio
b Department of Pathology, The Ohio State University College of Medicine, Columbus, Ohio
c Department of Neurology, The Ohio State University College of Medicine, Columbus, Ohio
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Fig 1. A, SE T2-weighted image, TR = 750 ms, TE = 20 ms, FOV = 15 cm, matrix = 1024 x 1024, and section thickness = 1 mm.
B, Luxol fast blue stain at approximately 400x. Type 1 cortical lesion. The lesion involves the deeper cortical layers and is clearly seen on MR imaging (A) and barely noticeable by pathology (B).
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Fig 2. SE diffusion T2-weighted image, TR = 1000 ms, TE = 65 ms, FOV = 15 cm, matrix = 512 x 512, and thickness = 1 mm. Type 2 cortical lesions. These cortical lesions involve all layers of the cortex, and the normal trilaminar appearance is lost. The subcortical white matter is unaffected. Disorganization of the cortical layers is the hallmark of this pattern.
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Fig 3. SE T2-weighted image, TR = 750 ms, TE = 20 ms, FOV = 15 cm, matrix = 1024 x 1024, and section thickness = 1 mm. Type 3 cortical lesions. Bandlike areas of demyelination along the outer cortical layers spanning adjacent gyri result in extensive involvement of the cortex.
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Fig 4. A, Luxol fast blue stain at approximately 400x.
B, GRE T2-weighted image, TR = 500, TE = 11, FOV = 15 cm, matrix = 1024 x 1024, and section thickness = 1 mm. Type 4 cortical lesion. Involvement predominantly affects the subcortical U-fibers, resulting in a juxtacortical lesion extending into the cortex.
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Fig 5. SE T2-weighted image, TR = 750 ms, TE = 20 ms, FOV = 15 cm, matrix = 1024 x 1024, section thickness = 1 mm. Type 5 cortical lesions (arrows). Lesion extends from all layers of the cortex to the adjacent white matter. The adjacent white-matter involvement distinguishes these lesions from type 2 lesions, which are restricted to the layers of the cortex only.
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Fig 6. SE diffusion T2-weighted image, TR = 1000 ms, TE = 65 ms, FOV = 15 cm, matrix = 512 x 512, and section thickness = 1 mm. Type 6 cortical lesions. Small and multiple lesions that occur across the cortical ribbon in any layers of the cortex.
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Fig 7. A, GRE T2-weighted image, TR = 500, TE = 11, FOV = 15 cm, matrix = 1024 x 1024, and section thickness = 1 mm. Multiple patterns are evident within a region of interest in which 5 different patters of involvement of the cerebral cortex can be identified.
B, Corresponding FLAIR T2-weighted image at 1.5T for comparison fails to demonstrate the cortical lesions noted in A at 8T.
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