Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of Central Nervous System (CNS) characterized by atrophy of brain and spinalcord. Magnetic Resonance Imaging (MRI) is an established tool in diagnosis and follow-up of patient with MS. However, histopathological significance of some signal alterations in MRI is not yet fully understood. T1-hypointense non enhancing lesions are areas of relatively severe CNS damage with axonal loss and matrix disruption. These lesions, also called “black holes”, are considered a marker of microstructural damage in MS patients. The...

Patients: 18 patients with MS were enrolled in the study (table 1). MRI imaging analysis: MRI were acquired on a 3T scanner and included T1SE, FSPGR and TSET2 sequences (3-mm-slice thickness). Images were analyzed during multiple sessions by consensus of two experienced observers (one neuroradiologist and one neurologist). Lesion volume (LV) was obtained using manual segmentation technique on TSET2, T1SE and FSPGR sequences (Jim version 7.0, Xinapse System). The lesions number (LN) was counted on T1SE and FSPGR images. T1SE and FSPGR images were co-registered...

Compared to T1SE, FSPGR images showed a statistically significant higher LN (p<0.005). T1SE hypointense lesions had a statistically significant lower FA (p<0.005) and higher MD (p<0.005) values.

Compared to T1SE, FSPGR images allowed us to detect a statistically significant higher LN. FA and MD values inside T1SE lesions were compatible with more destructive tissue damage due to demyelination. Our exhibit suggests that FSPGR images could be able to show hypointense lesions characterized by less severe microstructural changes and this should be considered when using T1 “black holes” as a biomarker of tissue damage severity. However, our data are still preliminary and an extension of patients' cohort is expected.

Nicola Romano: Department of Health Sciences (DISSAL) - Radiology Section, University of Genoa, Genoa, Italy Caterina Lapucci: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy. Matteo Pardini: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy;Department of Neurology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy. Matilde Inglese: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy;Department of Neurology, Ospedale Policlinico San Martino IRCCS,...

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