In patients with multiple sclerosis, where are plaques typically found on MRI?

In patients with multiple sclerosis (MS), plaques are typically found in the periventricular areas on MRI. This characteristic location of plaques reflects the pathophysiology of MS, which involves demyelination of the white matter in the central nervous system. The periventricular regions, which are adjacent to the lateral ventricles of the brain, often show high signal intensity on T2-weighted MRI sequences. This finding is a classic hallmark of MS and helps in the diagnosis of the disease.

In addition to the periventricular areas, plaques can also be found in other regions, such as the cortical and juxtacortical areas, and along the brainstem and spinal cord; however, the periventricular distribution remains one of the most common and distinctive features seen on MRI for diagnosing MS. This pattern supports the idea that the disease primarily affects the white matter tracts as the immune system mistakenly attacks the myelin sheath, leading to the formation of these hyperintense lesions seen in imaging studies.