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Black Hole Assessment Method in Multiple Sclerosis

Mult Scler Relat Disord; ePub 2017 Dec 2; Adusumilli, et al

A method designed to classify and estimate the severity of T1-weighted hypointensities (persistent black and gray holes) within multiple sclerosis (MS) can add information to conventional imaging, a recent study found. 38 MS patients contributed images to the study. Intensities of lesions on T1-weighted scans were assessed relative to cerebrospinal fluid intensity using commercial software. Magnetization transfer imaging, diffusion tensor imaging, and clinical testing were performed to assess associations with T1w intensity-based measures. Researchers found:

  • Intensity-based assessments of T1w hypointensities were reproducible and achieved >90% concordance with expert rater determinations of “black” and “gray” holes.
  • Intensity ratio values correlated with magnetization transfer ratios (R=0.473) and diffusion tensor imaging metrics (R values ranging from 0.283 to −0.531) that have been associated with demyelination and axon loss.
  • Intensity ratio values incorporated into T1w hypointensity volumes correlated with clinical measures of cognition.


Adusumilli G, Trinkaus K, Sun P, et al. Intensity ratio to improve black hole assessment in multiple sclerosis. [Published online ahead of print December 2, 2017]. Mult Scler Relat Disord. doi:10.1016/j.msard.2017.11.020.