Black holes in multiple sclerosis (MS) are considered to be more indicative of axonal loss than T2 lesions. We employed three novel MRI techniques, sodium MRI, diffusion MRI via the spherical mean technique, and quantitative magnetization transfer to measure tissue sodium concentration (TSC, for axonal dysfunction), apparent axonal volume fraction (Vax, for axon loss), and macromolecular-to-free pool-size-ratio (PSR, for demyelination degree), respectively. The results showed significant differences of the measures between black holes and the contralateral normal appearing white matters, indicating the potential of using these techniques to provide more specific information on underlying pathology in MS.
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