Post-contrast Susceptibility Weighted Imaging in Multiple Sclerosis MRI Improves the Detection of Enhancing Lesions

• DOI: 10.1007/s00062-025-01508-5
• Publication Date: 2025-03-07T09:55:05Z
• Authors: Pablo Naval-Baudin; Karen Pérez-Alfonso; Albert Castillo-P...; Ignacio Martínez-...; Pablo Arroyo-Pereiro; Lucía Romero-Pinel; Nahum Calvo; Antonio Martinez-...; Mónica Cos; Sergio Martínez-Y...; Albert Pons-Escoda; Carles Majós
• Keywords: Susceptibility Weighted Imaging

MRI is essential for monitoring multiple sclerosis (MS). Contrast-enhanced T1-weighted imaging (T1WI+C) detects active inflammatory lesions indicating blood-brain barrier breakdown and relevant disease treatment optimization. Susceptibility-weighted (SWI) may be included in the protocol detecting MS-specific features, such as presence of central veins or paramagnetic rim lesions. However, post-contrast SWI (SWI+C) has an inherent "T1 shine-through effect" that enables visualization contrast-enhancing This study evaluates whether SWI+C addition to standard T1WI+C improves detection enhancing patients with MS. The images 310 MS who underwent a standardized including using 3T scanner were retrospectively reviewed. A neuroradiologist radiology resident independently evaluated obtained on alone plus SWI+C. efficacy was compared detected 117 123 108 121 interobserver agreement improved from 0.981 1.00 Adding consistently enhances agreement. If standardized, this combined approach allow earlier activity improve progression, potentially leading optimized decisions patient outcomes.