In-vivo Quantitative Measure of Black Hole Severity in Multiple Sclerosis with Gradient Echo Plural Contrast Imaging

Introduction: Among the different types of MS brain lesions observed by MRI, black holes are thought to be most associated with significant tissue destruction including axonal loss [1]. Black holes are usually detected as hypointense areas compared to the normal appearing white matter (NAWM) on T1-weighted (T1w) images generated by conventional turbo-spin-echo (SE) MRI sequences. Unfortunately, these images, being only qualitative, provide limited information about lesion severity and have limited value for predicting lesions evolution over time. A recently introduced new MRI technique, named Gradient Echo Plural Contrast Imaging (GEPCI) [2-3], demonstrated substantial improvement in image quality and MRI acquisition time as compared to clinical sequences for evaluation of MS white matter lesions in humans [4]. In this abstract, we present preliminary results showing that GEPCI technique can be used as an efficient tool for quantitative assessment of black hole severity and has potential to be used to evaluate the level of tissue injury in MS lesions.