Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance

Background: Hypointense lesions on T1-weighted images have important clinical relevance in multiple sclerosis patients. Traditionally, spin-echo (SE) sequences are used to assess these (termed black holes), but Fast Spoiled Gradient-Echo (FSPGR) provide an excellent alternative. Objective: To determine whether the contrast difference between T1 hypointense and surrounding normal white matter is similar two sequences, different lesion types could be identified, of different. Methods: Seventy-nine patients' were manually segmented, then registered sequences. Median intensity values identified all K-means clustering was applied distinct clusters can defined based SE, FSPGR, FLAIR The standardized each cluster compared appearing order see if stand out from a given sequence. Results: 100% FSPGR 69% SE sequence #1 exceeded distance Z = 2.3 ( p < 0.05). In #2, 78.7% only 17.7% above this cutoff value, meaning that not easily seen images. Lesion count second (lesions less identifiable SE) significantly correlated with Expanded Disability Status Scale (EDSS) R : 0.30, ≤ 0.006) disease duration 0.33, 0.002). Conclusion: We showed holes separated into their various one which related parameters. This emphasizes joint role monitoring MS patients provides insight MS.