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What Is The Difference Between T1 and T2 Lesions on the MRI Scan?

5/6/2014

 
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Here is your MRI 101 answer:

1. T2 lesions are the white spots observed on MRI using the typical imaging sequences acquired to diagnose and monitor Multiple Sclerosis. The most popular of these sequences is a FLAIR image (this stands for Fluid Attenuated Inversion Recovery).

FLAIR images are used to subtract away the white appearance of water in and around the brain (mostly Cerebrospinal fluid) that interferes with visualization of brain tissue. When the area or “lesion” in the brain is white on T2 weighted images, this could mean the area is undergoing a temporary process like inflammation and will recover completely or the area has undergone permanent scaring. We are not able to differentiate these very different outcomes within the tissue by this imaging sequence alone .

2. T1 lesions are black spots or “holes” observed within the white matter of the brain. The T1 lesions or “black holes” within the brain can be caused by temporary process like acute inflammation or permanent scaring and tissue damage. The way to determine if a “black hole” is a permanent scar is to determine if it persists over a period usually greater than 3 months. Usually, the blacker the lesion the more you can be sure that the tissue in the region has been destroyed. Eventually, the tissue is replaced entirely by water and appears totally black on T1 weighted sequences and FLAIR sequences.

-Rip Kinkel, MD

Tracy Mccann
5/6/2014 12:54:12 pm

Dr k,

Thanks for making it so easy to understand. We miss you in Boston

Tracy

PG
5/16/2014 01:48:09 am

Thank you Dr. Kinkel. This was very helpful. We are glad to have you here in San Diego.

John Ashford
8/10/2015 11:23:48 pm

Helpful explanation of T1 & T2 type lesions.

Pat
10/2/2016 12:09:17 pm

How often should an MS patient have an MRI of the brain?What specific type of MRI should one have? How often for someone w lesions also in the spinal cord? Thank you in advance. Patricia

Patricia
11/22/2016 05:07:51 pm

Is there a relatively common/standard frequency of MRIs to distinguish & monitor permanent and transitory inflammation as represented by white and black lesions? Spinal cord? Grey & white matter volume? Brain atrophy? Thanks.

Deborah Tefertiller
5/22/2018 08:42:09 pm

I would very much like to hear the answer to Patricia's question above. It was posted in 2016 but I see no answer. Thank you.


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      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
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