Routine T1/T2-weighted magnetic resonance imaging (MRI) is the method of choice for diagnosis and treatment monitoring of Multiple Sclerosis (MS), but is not being able to map the underlying pathological processes. In contrast to T1/T2-lesions which represent the general macroscopic tissue damage, MR Spectroscopic Imaging (MRSI) can detect pathologies on a biochemical level. In 54 relapsing-remitting (RRMS) patients and 16 healthy age/sex-matched controls, we show - enabled through ultra-high resolution Free Induction Decay(FID)-MRSI at 7T - the metabolic distribution within lesions and their close proximity as well as the importance of myo-Inositol as an imaging biomarker in early lesion development.
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