Multiple sclerosis is an autoimmune disorder characterized by focal inflammatory demyelination. We combined quantitative susceptibility mapping (QSM) with histopathology on MS autopsy tissue to identify chronic activation of iron-positive macrophages/microglia. We demonstrate that the QSM susceptibility pattern gives insight into the lesion inflammatory state. Only rim positive lesions indicate smoldering inflammation in the presence of iron, and therefore are of particular relevance in the clinic.
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