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Fluid-attenuated inversion recovery (FLAIR) is a magnetic resonance imaging sequence with an inversion recovery set to null fluids. For example, it can be used in brain imaging to suppress cerebrospinal fluid (CSF) effects on the image, so as to bring out the periventricular hyperintense lesions, such as multiple sclerosis (MS) plaques. [ 1 ]
Fluid-attenuated inversion recovery (FLAIR) [2] is an inversion-recovery pulse sequence used to nullify the signal from fluids. For example, it can be used in brain imaging to suppress cerebrospinal fluid so as to bring out periventricular hyperintense lesions, such as multiple sclerosis plaques.
The first MR images of a human brain were obtained in 1978 by two groups of researchers at EMI Laboratories led by Ian Robert Young and Hugh Clow. [1] In 1986, Charles L. Dumoulin and Howard R. Hart at General Electric developed MR angiography, [2] and Denis Le Bihan obtained the first images and later patented diffusion MRI. [3]
Demyelinating lesions begin with the appearance of some areas named NAWM (normal appearing white matter) which despite its name, is abnormal in several parameters. These areas show axonal transections and stressed oligodendrocytes (the cells responsible for maintaining the myelin), and randomly, they show clusters of activated microglia named ...
The key to Phase-contrast MRI (PC-MRI) is the use of a bipolar gradient. [4] A bipolar gradient has equal positive and negative magnitudes that are applied for the same time duration. The bipolar gradient in PC-MRI is put in a sequence after RF excitation but before data collection during the echo time of the generic MRI modality.
Tumefactive demyelination is distinguished from tumor by the presence of multiple lesions, absence of cortical involvement, and decrease in lesion size or detection of new lesions on serial imaging [37] Tumefactive lesions can appear in the spinal cord, making the diagnosis even more difficult.
Most of the brain in MS is unaffected. Though obviously normal white matter appears normal under MRI, so does the NAWM white matter described in the next section. To establish a difference, normal white matter is named Non-lesional white matter (NLWM) [134] This normal white matter is reported to be around 56% of the total WM of the patients. [135]
Magnetic resonance imaging of the brain and spine may show areas of demyelination (lesions or plaques). Gadolinium can be administered intravenously as a contrast agent to highlight active plaques and, by elimination, demonstrate the existence of historical lesions not associated with symptoms at the moment of the evaluation.