An analysis of typical and atypical MRI findings of brain lesions in multiple sclerosis: a 82 cases report

Abstract

Objective To analyse the typical and atypical magnetic resonance imaging (MRI) findings of brain multiple sclerosis (MS) lesions in Chinese MS patients. Methods MRI findings of 82 Chinese MS patients who fulfilled McDonald criteria were reviewed retrospectively. The analysis items included the distribution, size, number, shape, intensity and enhancement of all lesions on head MRI. Results The typical MRI findings of these patients were as follow: 1) most lesions were located at periventricle area (62 cases, 75.61%) and the deep part of supratentorial white matter (55 cases, 67.07%); 2) there were over 10 lesions in 62 cases (75.61%); 3) the lesions were predominantly ≤ 1 cm (62 cases, 75.61%), and the next were > 5 cm (23 cases, 28.05%); 4) intensity and enhancement features presented T1WI iso ⁃ or hypo ⁃ intensity, T2WI hyperintensity, and proton density weighted image (PDWI) lesions intensity higher than water in the ventricle; the black hole appeared in various size and mostly with round or patchy shape; nodular enhancement was more often seen in lesions smaller than 1 cm and ring⁃like in middle size lesions; peripheral or irregular enhancement was popular for big lesions and arc ⁃ like for subcortical lesions. In the atypical MRI findings: 1) lesions were large [maximum diameter > 5 cm (23 cases, 28.05%)]; 2) lesion enhancement was remarkable and last longer; 3) brain stem lesions were more common (61 cases, 74.39%). Conclusion Multiple and small lesions at periventricle area or deep white matter are the typical MRI findings for MS. Deformation due to MS lesions, micro⁃ black hole at convex or line⁃shape black hole at periventricle, arc ⁃ like enhancement for juxtacortical lesions or enhancement beside the temporal horn are improtant in the diagnosis of MS. Big lesions with remarkable enhancement and prevalent in brain stem are the findings in Chinese MS patients which are different from American or European MS cases. DOI：10.3969/j.issn.1672-6731.2011.03.01