Fig. 1.

We used synthetic magnetic resonance imaging to visualize brain changes in a patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). A synthetic fluid attenuated inversion recovery (FLAIR) image (A) shows hyperintense lesions in both anterior temporal poles. Synthetic double inversion recovery (DIR) imaging (B) is superior to FLAIR imaging for detection of these hyperintense lesions, particularly in the left anterior temporal pole (arrow). Synthetic T₁-weighted (C) and phase-sensitive inversion recovery (PSIR) (D) images show hypointense lesions in both anterior temporal poles, visualized more clearly on the PSIR image, particularly in the left anterior temporal pole (arrow). Decrease in volume of myelin in these lesions is evident on the myelin map overlaid on the T₂-weighted image (E).