To describe relationships between properties of multiple sclerosis (MS) lesions on quantitative susceptibility mapping (QSM) and several clinical metrics.

Susceptibility MRI studies have shown that techniques such as phase and QSM reveal lesion heterogeneity in MS, including the presence of lesions with outer rims suggestive of iron deposition. In this project, we aimed to evaluate possible correlations between clinical characteristics in MS patients and QSM lesion rims on 7 tesla (7T) MRI.

39 patients with MS underwent 7T brain MRIs and clinical evaluation. Lesions were identified on FLAIR. QSM images were reviewed for contrast patterns at the edge of these lesions. The proportions of lesion subtypes were compared to demographic characteristics and disability scores.

A total of 1279 lesions were identified on FLAIR MRI; 846 (66.15%) of these were visible on QSM, 119 of which had visible rims. Disability scores tended to be worse in those with rims, most of these relationships were not significant. Lesions visible on QSM were more likely to have rims in males (16.1%, vs 4.9% in females, p=0.009). Of the 18 participants (46.2%) with at least 1 rimmed lesion, 61.1% were male; only 19.0% without rims were male (p=0.006). In a logistic regression model accounting for the total number of lesions and age, male sex conferred a nearly 7-fold risk of having ≥1 rimmed lesion(s) (p=0.018).