Multiple sclerosis (MS) diagnostic criteria are based upon clinical presentation and presence of white matter hyperintensities on two-dimensional magnetic resonance imaging (MRI) views. Such criteria, however, are prone to false-positive interpretations due to the presence of similar MRI findings in non-specific white matter disease (NSWMD) states such as migraine and microvascular disease. The coexistence of age-related changes has also been recognized in MS patients, and this comorbidity further poses a diagnostic challenge. In this study, we investigated the physiologic profiles within and around MS and NSWMD lesions and their ability to distinguish the two disease states. MS and NSWMD lesions were identified using three-dimensional (3D) T₂-FLAIR images and segmented using geodesic active contouring. A dual-echo functional MRI sequence permitted near-simultaneous measurement of blood-oxygen-level-dependent signal (BOLD) and cerebral blood flow (CBF). BOLD and CBF were calculated within lesions and in 3D concentric layers surrounding each lesion. BOLD slope, an indicator of lesion metabolic capacity, was calculated as the change in BOLD from a lesion through its surrounding perimeters. We observed sequential BOLD signal reductions from the lesion towards the perimeters for MS, while no such decreases were observed for NSWMD lesions. BOLD slope was significantly lower in MS compared to NSWM lesions, suggesting decreased metabolic activity in MS lesions. Furthermore, BOLD signal within and around lesions significantly distinguished MS and NSWMD lesions. These results suggest that this technique shows promise for clinical utility in distinguishing NSWMD or MS disease states and identifying NSWMD lesions occurring in MS patients.

多发性硬化症（MS）诊断标准基于临床表现和二维磁共振成像（MRI）视图上的白质高信号。但是，由于在偏头痛和微血管疾病等非特定性白质疾病（NSWMD）状态下存在类似的MRI发现，因此此类标准易于产生假阳性解释。在MS患者中也已认识到与年龄相关的变化并存，这种合并症进一步提出了诊断挑战。在这项研究中，我们调查了MS和NSWMD病变内和周围的生理特征及其区分两种疾病状态的能力。使用三维（3D）T ₂识别MS和NSWMD病变-FLAIR图像，并使用测地线主动轮廓进行分割。双回波功能MRI序列允许几乎同时测量血氧水平依赖性信号（BOLD）和脑血流量（CBF）。在病变内以及围绕每个病变的3D同心层中计算了BOLD和CBF。BOLD斜率是病变代谢能力的指标，计算为从病变到周围周围的BOLD变化。对于MS，我们观察到从病灶向周界的连续BOLD信号减少，而对于NSWMD病灶则未观察到这种减少。与NSWM病变相比，MS的BOLD斜率明显更低，表明MS病变的代谢活性降低。此外，病变内和周围的BOLD信号显着区分了MS和NSWMD病变。