# T2-fluid attenuated inversion recovery fat-suppressed mismatch in the identification and characterization of lesions related to radiologically isolated syndrome

## TL;DR

This paper explores how a fat-suppressed T2-FLAIR MRI sequence helps identify and characterize brain lesions linked to radiologically isolated syndrome, a condition with MS-like MRI findings but no neurological symptoms.

## Contribution

The study introduces the use of fat-suppressed T2-FLAIR mismatch to better identify inflammatory demyelination lesions in radiologically isolated syndrome.

## Key findings

- Fat-suppressed T2-FLAIR mismatch improves lesion identification in radiologically isolated syndrome.
- The technique provides morphological insights into disease severity and lesion characteristics.
- T2-FLAIR mismatch may help differentiate inflammatory demyelination from other lesion types.

## Abstract

The radiologically isolated syndrome is defined by the presence of incidentally identified T2-weighted hyperintense lesions, highly suggestive of central nervous system demyelination, following an MRI study that is performed for reasons other than for the investigation of symptoms related to multiple sclerosis (MS). These individuals also have no evidence of prior neurological symptoms associated with inflammatory demyelination and no alternative explanation for the observed MRI findings. Recently, the introduction of novel imaging techniques such as the “central vein sign” has improved lesion specificity for MS. In addition, the observation of T2-fluid attenuated inversion recovery (FLAIR) mismatch characteristics associated with gliomas and in those with MS with a higher disease burden appear to provide morphological data that relate to disease severity. The value of T2-FLAIR mismatch characteristics in discrete multi-focal lesions has not yet been well defined. Here, we present the value of a fat-suppressed T2-FLAIR sequence in the identification and characterization of T2-weighted hyperintensities resulting from inflammatory demyelination.