Hidden Pitfall in Multiple Sclerosis Imaging: How Standard Susceptibility-Weighted Imaging (SWI) May Miss Paramagnetic Rim Lesions
This case report shows that paramagnetic rim lesions (PRLs), markers of chronic active lesions in multiple sclerosis, vary in visibility depending on scan-parameters of susceptibility-weighted imaging (SWI). Routine SWI for microbleed detection with low flip angle (FA) failed to depict PRLs, while longer TE and higher FA improved visibility. Phase images consistently visualized PRLs. These findings underscore the need to optimize TE and FA, as suboptimal SWI settings may hinder PRL detection.
Authors
- Hiroshi Kusahara (ORCID: https://orcid.org/0000-0002-3535-3338)
- Akifumi Hagiwara (ORCID: https://orcid.org/0000-0001-5277-3249)
- Yuji Tomizawa (ORCID: https://orcid.org/0000-0002-5462-6725)
- Junko Kikuta (ORCID: https://orcid.org/0000-0003-1324-8614)
- Ryutaro Yano (ORCID: https://orcid.org/0009-0008-1938-141X)
- Taku Hatano (ORCID: https://orcid.org/0000-0002-6808-0444)
- Moto Nakaya (ORCID: https://orcid.org/0000-0001-7697-6286)
- Satoru Kamio
- Koji Kamagata (ORCID: https://orcid.org/0000-0001-5028-218X)
- Shigeki Aoki (ORCID: https://orcid.org/0000-0002-8491-0698)
- Hideo Kawasaki (ORCID: https://orcid.org/0000-0002-1942-9363)
- Yuki Sonoda (ORCID: https://orcid.org/0009-0005-8622-2433)
- Yasunobu Hoshino
Institutions
- Canon (Japan) (JP)
- Juntendo University (JP)
- The University of Tokyo (JP)
Publication Details
- Journal
- Magnetic Resonance in Medical Sciences
- Published
- 2025-08-08
- DOI
- https://doi.org/10.2463/mrms.bc.2025-0073
- Primary Topic
- Multiple Sclerosis Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00