During a relapse in multiple sclerosis, what is a typical MRI finding?

During a relapse in multiple sclerosis, what is a typical MRI finding?

• A. Active plaques enhancing with gadolinium
• B. No plaques on T2
• C. Hemorrhagic plaques
• D. Widespread cortical atrophy only

Answer: (B)

Relapses in multiple sclerosis are driven by acute inflammatory activity that disrupts the blood–brain barrier. On MRI, this shows up as new or enlarging lesions that take up gadolinium contrast, so you see active plaques that enhance after contrast administration. This enhancement indicates active demyelination and ongoing inflammation, which aligns with a clinical relapse. In contrast, simply seeing non-enhancing lesions on T2-weighted imaging can reflect past damage, not an active attack. Hemorrhagic plaques are not a typical feature of MS lesions, and widespread cortical atrophy describes longer-term neurodegeneration rather than the acute change seen during a relapse.

Relapses in multiple sclerosis are driven by acute inflammatory activity that disrupts the blood–brain barrier. On MRI, this shows up as new or enlarging lesions that take up gadolinium contrast, so you see active plaques that enhance after contrast administration. This enhancement indicates active demyelination and ongoing inflammation, which aligns with a clinical relapse. In contrast, simply seeing non-enhancing lesions on T2-weighted imaging can reflect past damage, not an active attack. Hemorrhagic plaques are not a typical feature of MS lesions, and widespread cortical atrophy describes longer-term neurodegeneration rather than the acute change seen during a relapse.