Figure 12.

Quantitative susceptibility mapping for quantifying a mixture of paramagnetic and diamagnetic biomaterials. (i) Acute enhancing lesions in a 32-year-old male with RRMS at two time points: initial study (T1w + c1 and QSM1, 1st row) and 3-month follow-up (T1w + c2 and QSM2, 2nd row) (T1w + c – T1-weighted imaging with Gd). Lesions appear in the right frontal WM (white arrows) and in the lcc (black arrows). Both lesions are enhancing (arrows) on T1w + c1 and isointense (white boxes) on QSM1. The lesions changed on follow up to nonenhancing on T1w + c2 and hyperintense on QSM2 (arrows). The right frontal WM matter lesion shrunk between QSM1 and QSM2. The lcc lesion (black arrow) recovered to normal appearing on T2w and T1w (not shown), T1w + c. (ii) Nonenhancing lesions (33y, f, RRMS) on QSM at two time points (2nd row was 6 months later). All QSM lesions at time point 1 were estimated to be 1.2y using prior MRIs. All lesions (arrows) are QSM hyperintense on both time points with similar values. (iii) Chronic nonenhancing lesions (50y f RRMS) on QSM and T2W. Two lesions over 10 years old were detected (white arrows). They appear isointense on both QSM (white boxes, only initial study shown). lcc, left cingulate cortex; QSM, quantitative susceptibility mapping; RRMS, relapsing-remitting multiple sclerosis; WM, white matter. Source: Chen et al, Radiology 2014;271:183–192.