Table 1:

MR imaging characteristics in multiple sclerosis

MethodsClassic Imaging Features
Conventional MRIMultiple lesions: periventricular > peripheral
Ovoid shape
Dilated perivascular space
Optic nerve, U fiber, and callosal involvement
Generalized atrophy at relatively younger age
Enhancing lesions (ring, rim, or solid)
Gradually increased number of lesions
MTRDecrease in lesions
Decrease in NAWM—precede new lesion
Lower in nonenhancing than in enhancing lesions
Lower in ischemic than in demyelinating lesions
Lowest in the core of ring enhancing lesion
Lower in gray matter than in white matter
DTIHigher MD and lower FA in lesions than in NAWM
Higher MD and lower FA in NAWM than in normal white matter
Not reliable to differentiate enhancing and nonenhancing lesions
Not significant in NAWM in early stage of disease
Visualization of specific fiber tract on tractography
Perfusion imagingDecreased CBF and CBV in general
Locally increased CBV in enhancing lesions
Locally increased CBV in some chronic lesions
1H-MR spectroscopyMarked decrease of NAA level
Increase of choline
Presence of lipid
Spinal imagingMultiple lesions
Cervical spinal cord (peripherally located)
Asymptomatic lesions
Less than 2 vertebral bodies in length
Focal atrophy
  • Note:—MTR indicates magnetization transfer ratio; DTI, diffusion tensor imaging;

  • 1 H-MR spectroscopy, proton MR spectroscopy; NAWM, normal appearing white matter; MD, mean diffusivity; FA, fractional anisotropy; CBF, cerebral blood flow; CBV, cerebral blood volume; NAA, N-acetylaspartate.