WebIs T2 FLAIR hyperintensity normal? Background: T2-hyperintense foci are one of the most frequent findings in cerebral magnetic resonance imaging (MRI). ARWMC - age related white matter changes. Google Scholar, Yoshita M, Fletcher E, Harvey D, Ortega M, Martinez O, Mungas DM: Extent and distribution of white matter hyperintensities in normal aging, MCI, and AD. It provides excellent visuals of soft tissue and allows the diagnosis of the following: Doctors measure hyperintensity by evaluating the imaging reports. For more information, please visit: IggyGarcia.com & WithInsightsRadio.com, Welcome to Iggy Garcia, The Naked Shaman Podcast, where amazing things happen. Most MRI reports are black and white with shades of gray. Prospective studies in elderly cohorts with minimal MRI-autopsy delay including DTI and MT sequences, assessment of the glial pathology associated with WMHs and quantitative radio-pathological evaluation are warranted to clarify the significance of WMHs in the course of brain aging. It helps in detecting different mental disorders. It provides a more clear and visible image of the tissues. All included cases had axial spin-echo T2 and coronal FLAIR imaging. While these findings are non specific they are commonly seen with chronic microvascular ischemic change. White spots on a brain MRI are not always a reason to worry. What it means Signal area hyperintense on T2 and FLAIR in the white matter anterior to the left nucleus-capsular region, which may represent an area of encephalomalacia.. Stroke 1997, 28: 652659. These small regions of high intensity are observed on T2 weighted MRI images (typically created using 3D FLAIR) The severity of demyelination in postmortem tissue was positively associated with the WMH lesion score both in periventricular and deep WM areas. Top Magn Reson Imaging 2004, 15: 365367. Although all of the cases had no major cognitive deficits and clinically overt depression, we cannot exclude the presence of subtle neuropsychological deficits or subsyndromal depression that may be related to WMHs. MRI said few tiny discrete foci of high signal on FLAIR sequences in the deep white matter in the cerebellum, possibly part of chronic small vessel disease. The ventricles and basilar cisterns are symmetric in size and configuration. Be sure to check your spelling. Therefore, the doctors focus on neurological evaluation when assessing the MRI reports providing the diagnosis accordingly.. They are considered a marker of small vessel disease. Untreated, it can lead to dementia, stroke and difficulty walking. The presence of nonspecific white matter hyperintensities may cause uncertainty for physicians and anxiety for patients. White spots on a brain MRI are not always a reason to worry. Probable area of injury. 2023. In order to explore whether a simple qualitative approach improves the inter-rater agreement, the same analysis was performed for the presence/absence of lesions. IggyGarcia.com & WithInsightsRadio.com. WebHyperintensities are often not visible on other types of scans, such as CT or FLAIR. Additionally, axial T1w, T1w after Gadolinium administration and T2*w images were analyzed to rule out concomitant brain pathological findings. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. For more information, please visit: IggyGarcia.com & WithInsightsRadio.com, For more information, please visit: In the latter case, the result is interpreted as a significant over- or under-estimation. There are several different causes of hyperintensity on T2 images. These areas are hyperintense on T2-weighted (T2) and fluid-attenuated inversion recovery (FLAIR) MRI sequences, and by consensus are now referred to as white matter hyperintensities (WMH), or subcortical hyperintensities where deep gray matter is also involved. WebAnswer (1 of 8): White matter hyperintensities (WMHs) are signal abnormalities in the white matter of the brain found on T2-weighted , fluid-attenuated inversion recovery (FLAIR), and proton density magnetic resonance imaging (MRI) sequences. There are many possible causes, including vitamin deficiencies, infections, migraines, and strokes. Neurology 1995, 45: 883888. There are seve= ral (approximately eight) punctate foci of T2 and FLAIR hyperintensit= y within the cerebral white matter. These white matter hyperintensities are an indication of chronic cerebrovascular disease. And I Periventricular White Matter Hyperintensities on a T2 MRI image Other risk factors for white spots include getting older, race/ethnicity, genetics, obesity, diabetes, hypertension, and high cholesterol. Matthews about dizziness, there can be few physicians so dedicated to their art that they do not experience a slight decline in spirits when they learn that a patients brain MRI shows nonspecific white matter T2-hyperintense lesions compatible with microvascular disease, demyelination, migraine, or other causes. Using MRI scans as a diagnostic approach helps in managing effective clinical evaluation. No evidence of midline shift or mass effect. Major imaged intracranial flow = voids appear normally preserved. Neuro patients going in for head and cervical MRI should ask to see if they are being imaged on a 3.0 Tesla MRI using an MS imaging protocol. Sensitivity value for radiological cut-off was excellent at 100% (95% CI: 48% - 100%) but specificity was modest at 43% (95% CI: 25% - 63%). They can be seen for no good reason, perhaps more often with a history of migraines, more likely with a history of hypertension and other risk factors for atherosclerosis. Treatment typically involves reducing or managing risk factors, such as high blood pressure, cholesterol level, diabetes and smoking. T1 Scans with Contrast. Lesions are not the only water-dense areas of the central nervous system, however. The present study revealed that brain T2/FLAIR sequence-identified WMHs overestimated demyelination in the periventricular and perivascular regions but underestimated it in the deep WM during normal brain aging. WebWith the wide use of brain MRI, white matter hyperintensity (WMH) is frequently observed in clinical patients. Overall, the MRI scans are highly beneficial in detecting health disorders, allowing proactive designing of the treatment plans. Representative examples of the concordance between brain MRI WMHs and demyelination. walking slow. 2 doctor answers 5 doctors weighed in Share Dr. Paul Velt answered Diagnostic Radiology 44 years experience Small vessel disease: The latest studies point to small vessels also called microscopic vessels. Primary differential considerations include sequela of previous infection or trauma, sequela migraine headaches or sequela of minimal chronic small vessel ischemic. This tissue contains millions of nerve fibers, or axons, that connect other parts of the brain and spinal cord and signal your nerves to talk to one another. WMHs are associated with vascular risk factors such as diabetes, smoking and hypertension and hence WMHs are considered part of small vessel disease. Detecting WMHs by diagnostic brain imaging gives clinicians an opportunity to screen for other vascular risk factors and proactively treat them. The subcortical white matter is just a little bit deeper than the gray matter of the cerebral cortex. Arch Neurol 2010, 67: 13791385. Focal hyperintensities in the subcortical white matter demonstrated by T2-weighted or FLAIR images are a common incidental finding in patients undergoing brain MRI for indications other than stroke. Scattered T2 and FLAIR hyperintense foci identified in subcortical and periventricular white matter which are nonspecific. Z-tests were used to compare kappa with zero. White matter hyperintensities (WMHs) are lesions in the brain that show up as areas of increased brightness when visualised by T2-weighted magnetic resonance imaging (MRI). These also involve different imaging patterns that highlight the different kinds of tissues. You dont need to panic as most laboratories have advanced wide-bore MRI and open MRI machines. Manage cookies/Do not sell my data we use in the preference centre. WebMicrovascular Ischemic Disease. Arch Gen Psychiatry 2009, 66: 545553. An MRI report can call white matter changes a few different things, including: Cerebral or subcortical white matter disease or lesions. Radiologists overestimated these lesions in 16 cases. They are indicative of chronic microvascular disease. Finally, this study focused on demyelination as main histopathologic lesion. The agreement between neuropathologists was substantial both for periventricular (kappa of 0.65; 95% CI: 0.60 - 0.85; p<0.0001) and deep WM demyelination (kappa of 0.78; 95% CI: 0.59 - 0.95; p<0.0001)). Even when adjusting for vascular disease risk factors, such as age and high blood pressure, this association was still significant. WebWhite matter hyperintensities are common in MRIs of asymptomatic individuals, and their prevalence increases with age from approximately 10% to 20% in those approximately 60 years old to close to 100% in those older than 90 years. WebThe T2 MRI hyperintensity is often a sign of demyelinating illnesses. WebFocal hyperintensities in the subcortical white matter demonstrated by T2-weighted or FLAIR images are a common incidental finding in patients undergoing brain MRI for indications other than stroke. I dropped them off at the neurologist this morning but he isn't in until Tuesday. In a first step, we assessed the inter-rater agreement using kappa statistics presented with 95% confidence interval (95% CI). As is usually the case for neuropathologic analyses, the retrospective design represents an additional limitation of our study. 10.1016/j.jocn.2011.01.008, Smith EE, Salat DH, Jeng J, McCreary CR, Fischl B, Schmahmann JD: Correlations between MRI white matter lesion location and executive function and episodic memory. WebFluid-attenuated inversion recovery (FLAIR) is an MRI sequence with an inversion recovery set to null fluids. Access to this article can also be purchased. 10.1093/brain/114.2.761, Young VG, Halliday GM, Kril JJ: Neuropathologic correlates of white matter hyperintensities. (A) Good correlation between radiology and pathology for both periventricular (arrowhead) and deep WM (arrow) lesions; (B) radiological assessment over-estimating periventricular lesions; (C) under-estimating deep WM lesions; (D) over-estimating periventricular lesions and under-estimating deep WM lesions. All of the cases included in the present series presented with high MMSE scores compatible with normal cognitive functioning and absence of major depression. We used to call them UBOs; Unidentified bright objects. The subcortical white matter is just a little bit deeper than the gray matter of the cerebral cortex. Whether these radiological lesions correspond to irreversible histological changes is still a matter of debate. Gouw AA, Seewann A, van der Flier WM, Barkhof F, Rozemuller AM, Scheltens P: Heterogeneity of small vessel disease: a systematic review of MRI and histopathology correlations. Please add some widgets by going to. Biometrics 1977, 33: 159174. An MRI report can call white matter changes a few different things, including: Cerebral or subcortical white matter disease or lesions. White spots on a brain MRI are not always a reason to worry. The assessment of the MRI hyperintensity lesions assists in diagnosing neurological disorders and other psychiatric illnesses.. ); Debette et al., The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis, BMJ 2010; 341: c3666. EK and CB did data collection and histological analyses. In medicine, MRI hyperintensity is available in three forms according to its location on the brain. The multifocal periventricular and posterior fossa white matter lesions have an appearance typical of demyelinating disease. Among these lesions, degeneration of myelin is the most frequently encountered in old age and may take place long before the emergence of cognitive or affective symptoms [14]. ARWMC - age related white matter changes. Another study revealed that severe white subcortical WMHs (odds ratio 5.4) were more likely to have depressive symptoms compared to periventricular matter lesions (odds ratio 3.3) [37]. The Rotterdam and the Framingham Offspring Study showed an association between WMHs and mortality independent of vascular risk events and risk factors. Matthews about dizziness, there can be few physicians so dedicated to their art that they do not experience a slight decline in spirits when they learn that a patients brain MRI shows nonspecific white matter T2-hyperintense lesions compatible with microvascular disease, demyelination, migraine, or other causes. We are but a speck on the timeline of life, but a powerful speck we are! Iggy Garcia. Acta Neuropathol 2007, 113: 112. Patients with migraine are at increased risk for white matter hyperintensities detected on magnetic resonance imaging. Appointments & Locations. Originally just called "FLAIR", this technique was developed in the early 1990's by the Hammersmith research team led by Graeme Bydder, Joseph Hajnal, and Ian Young. This is clearly not true. It provides valuable and accurate information that helps in planning treatments and surgery., Magnetic Resonance Imaging involves the use of a resilient magnetic field and radio waves. The corresponding Luxol-van Gieson (LVG)-stained histological slides were analyzed by both pathologists assessing the degree of demyelination around the perivascular spaces. Scale bar=800 micrometers. We report the radiologic-histopathologic concordance between T2/FLAIR WMHs and neuropathologically confirmed It also acts as a practical framework that allows the radiologists to plan the overall treatment., When examining the MRI scan, doctors and radiologists look for the MRI hyperintensity. The corresponding histopathology confirms the presence of prominent perivascular spaces, yet there is no significant demyelination around the perivascular spaces, which would correspond to the confluent hyperintense T2/FLAIR signal alteration. None are seen within the cerebell= um or brainstem. Areas of new, active inflammation in the brain become white on T1 scans with contrast. Bilateral temporal lobe T2 hyperintensity refers to hyperintense signal involving the temporal lobes on T2 weighted and FLAIR imaging. In addition, practitioners associate it with cerebrovascular disorders and other similar risks. The risk is high in people with a history of stroke and depression. WebBackground: T2-hyperintense foci are one of the most frequent findings in cerebral magnetic resonance imaging (MRI). She is very prolific in delivering the message of Jesus Christ to the world, bringing people everywhere into a place of the victory God has prepared for them. Kiddie scoop: I was born in Lima Peru and raised in Columbus, Ohio yes, Im a Buckeye fan (O-H!) Coronal slice orientation during analysis was the same for radiology and neuropathology. Normal vascular flow voids identified at the skull base. Scattered T2 and FLAIR hyperintense foci identified in subcortical and periventricular white matter which are nonspecific. Additionally, these changes are differentially distributed among those patients who are eventually classified as non-remitters, which indicates that the relationship between WMH accumulation and Late life depression (LLD) is consequential even during short antidepressant treatment courses. Sven Haller. WMHs are also referred to as Leukoaraiosis and are often found in CT or MRIs of older patients. We suggest that a possible explanation of this dissociation may reside in the differences in local concentration of interstitial water between these brain areas. Deep white matter hyperintensities (DWMHs) are associated with a more severe (melancholic) AND resistant form of depression [Khalaf A et al., 2015] and the patient is more likely to present with cognitive dysfunction, psychomotor slowing, and apathy. Periventricular White Matter Hyperintensities on a T2 MRI image They are indicative of chronic microvascular disease. Braak H, Braak E: Neuropathological stageing of Alzheimer-related changes. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. WebBackground: T2-hyperintense foci are one of the most frequent findings in cerebral magnetic resonance imaging (MRI). WebHyperintensities are often not visible on other types of scans, such as CT or FLAIR. Arch Gen Psychiatry 2000, 57: 10711076. BMJ 2010, 341: c3666. b A punctate hyperintense lesion (arrow) in the right frontal lobe. This scale is a 4 point one, based on MRI images with either proton density (PD), T2, or T2-FLAIR. What are white matter hyperintensities made of? As an academic I have published several scientific papers; as a medical writer I have written many articles in print and online, covering topics on ageing, brain health, anatomy,psychiatry, and nutrition. The pathophysiology and long-term consequences of these lesions are unknown. The other independent variables were not related to the neuropathological score. Transportation Service Available ! My 1.5 Tesla study was like flushing $1800 down the crapper. Matthews about dizziness, there can be few physicians so dedicated to their art that they do not experience a slight decline in spirits when they learn that a patients brain MRI shows nonspecific white matter T2-hyperintense lesions compatible with microvascular disease, demyelination, migraine, or other causes. Areas of new, active inflammation in the brain become white on T1 scans with contrast. I dropped them off at the neurologist this morning but he isn't in until Tuesday. Wolff SD, Balaban RS: Magnetization transfer contrast (MTC) and tissue water proton relaxation in vivo. Symptoms of white matter disease may include: issues with balance. In contrast to periventricular lesions, radiologists overestimated the pathology only in 3 cases and underestimated it in 10 cases (exact McNemar: p=0.092). The deep white matter is even deeper than that, going towards the center T-tests were used to compare regression coefficients with zero. PubMed We analyzed the pathological significance of T2/FLAIR sequences since they are the most widely available in routine clinical settings. Do brain T2/FLAIR white matter hyperintensities correspond to myelin loss in normal aging? [Read more on melancholic depression and association of WMHs with structural melancholia), They are also closely associated with late-onset depression and their progression is associated with worse outcomes in geriatric depression. Whether or not the frequent identification of T2/FLAIR WMHs in healthy elderly individuals represents an innocuous phenomenon or should be viewed as potentially harmful for brain structure is unknown. 10.1212/WNL.59.3.321, Topakian R, Barrick TR, Howe FA, Markus HS: Bloodbrain barrier permeability is increased in normal-appearing white matter in patients with lacunar stroke and leucoaraiosis. This is the most common cause of hyperintensity on T2 images and is associated with aging. Come and explore the metaphysical and holistic worlds through Urban Suburban Shamanism/Medicine Man Series. White Matter Hyperintensities on MRI Coincidental Finding or Something Sinister? To this end, the T1- and T2-weighted, as well as the T2-weighted FLAIR, magnetic resonance imaging (MRI) data obtained from migraine patients were analyzed to describe the imaging characteristics of WMHs. Radiology 1990, 176: 439445. We computed average scores within each group and then dichotomized the averaged scores using a threshold of 1.5. WebBackground: T2-hyperintense foci are one of the most frequent findings in cerebral magnetic resonance imaging (MRI). I dropped them off at the neurologist this morning but he isn't in until Tuesday. 10.1161/01.STR.28.3.652, O'Sullivan M, Lythgoe DJ, Pereira AC, Summers PE, Jarosz JM, Williams SC: Patterns of cerebral blood flow reduction in patients with ischemic leukoaraiosis. Usually this is due to an increased water content of the tissue. These lesions were typically located in the parietal lobes between periventricular and deep white matter. As a result, it makes it easier to detect abnormalities.. Focal hyperintensities in the subcortical white matter demonstrated by T2-weighted or FLAIR images are a common incidental finding in patients undergoing brain MRI for indications other than stroke. WebMri few punctate t2 and flair hyperintense foci in the periventricular white matter, likely related to chronic small vessel ischemia.what it means. The clinical significance of WMHs in healthy controls remains controversial. An MRI scan is one of the most refined imaging processes. Radiologic convention, right hemisphere on left hand side. Access to this article can also be purchased. MRI said few tiny discrete foci of high signal on FLAIR sequences in the deep white matter in the cerebellum, possibly part of chronic small vessel disease. Background: T2-hyperintense foci are one of the most frequent findings in cerebral magnetic resonance imaging (MRI). Normal vascular flow voids identified at the skull base. None are seen within the cerebell= um or brainstem. Three trained neuroradiologists evaluated brain T2w and FLAIR MRI of all 59 cases blind to the neuropathologic data. The association is particularly strong with cardiovascular mortality. Although more White matter hyperintensities (WMH) lesions on T2 and fluid attenuated inversion recovery (FLAIR) brain MRI are very common findings in elderly cohorts and their prevalence increases from 15% at the age of 60 to 80% at the age of 80 [14].Mainly located in the periventricular white matter (WM) and perivascular spaces, they can also be Advances in Kernel Methods-Support Vector Learning 1999, 208: 121. In the United States, you can find a network of imaging centers that facilitate patients. WMHS are significantly associated with resistant depression. Neuro patients going in for head and cervical MRI should ask to see if they are being imaged on a 3.0 Tesla MRI using an MS imaging protocol. Analysis of cohorts of consecutive subjects aged 55 to 85 years living at home. We cannot thus formally rule out a partial volume effect on MRI. PubMed They can be seen for no good reason, perhaps more often with a history of migraines, more likely with a history of hypertension and other risk factors for atherosclerosis. WebWhite matter hyperintensities are common in MRIs of asymptomatic individuals, and their prevalence increases with age from approximately 10% to 20% in those approximately 60 years old to close to 100% in those older than 90 years. These include: Leukoaraiosis. Sensitivity value for radiological cut-off was 38% (95% CI: 15% - 64%) but specificity reached 82% (95% CI: 57% - 96%). Although some WMH is associated with specific causes, such as lacunar infarction, traumatic brain injury, and demyelinating disease [13], some WMH has no specific cause, especially in young patients.Incidental WMH without a detected cause can be We will be traveling to Peru: Ancient Land of Mystery.Click Here for info about our trip to Machu Picchu & The Jungle. According to Scheltens et al. 10.1016/j.brainresrev.2009.08.003, Schmidt R, Berghold A, Jokinen H, Gouw AA, van der Flier WM, Barkhof F: White matter lesion progression in ladis: frequency, clinical effects, and sample size calculations. You dont need to panic as most laboratories have advanced wide-bore MRI and, The MRI hyperintensity is a common imaging feature in T2. Discordant pairs were analyzed with exact Mc Nemar significance probability. The coefficient of determination (R2) was used to assess the proportion of variance explained by the models. MRI brain: T1 with contrast scan. In no cases did they underestimate the underlying pathology (exact McNemar p<0.001). Non-specific white matter changes. The initial discovery of WMHs was made in the late 1980s by Hachinski and colleagues. It produces images of the structures and tissues within the body. Only in one case, they underestimated the underlying pathology (exact McNemar p<0.001). 10.1001/archneur.1991.00530150061019, van Swieten JC, van den Hout JH, van Ketel BA, Hijdra A, van Wokke JH, Gijn J: Periventricular lesions in the white matter on magnetic resonance imaging in the elderly. CAS Importantly, when the presence/absence of lesions was considered, kappa values did not change significantly for neuropathologists (0.74/95% CI:0.58-0.89 for periventricular and 0.65/95% CI: 0.28-0.99 for deep WM demyelination), improved for radiologists (0.57/95% CI: 0.37-078 for periventricular and 0.50/95% CI: 0.31-0.70 for deep WMHs) but became even worse for radiologic-pathologic correlations (0.05/95% CI:-0.11-0.01 for periventricular and 0.12/95% CI:-0.20-0.43 for deep WM lesions). 10.1212/01.wnl.0000249119.95747.1f, Krishnan MS, O'Brien JT, Firbank MJ, Pantoni L, Carlucci G, Erkinjuntti T: Relationship between periventricular and deep white matter lesions and depressive symptoms in older people. P values inferior to 0.05 were considered significant. My 1.5 Tesla study was like flushing $1800 down the crapper. https://doi.org/10.1186/2051-5960-1-14, DOI: https://doi.org/10.1186/2051-5960-1-14. Int J Geriatr Psychiatry 2006, 21: 983989. However, they are suboptimal to detect the whole range of WMHs and microstructural changes in old age. They can pose serious diagnostic problems which is reflected by their English name and abbreviation - UBOs (Unidentified Bright Objects). MRI showed some peripheral hyperintense foci in white matter. 10.1136/bmj.c3666, Article She is also the author of several books, including Seven Keys to Living in Victory, I am My Beloveds and The Cup Bearer. These areas are hyperintense on T2-weighted (T2) and fluid-attenuated inversion recovery (FLAIR) MRI sequences, and by consensus are now referred to as white matter hyperintensities (WMH), or subcortical hyperintensities where deep gray matter is also involved. Inter-rater reliability was substantial-almost perfect between neuropathologists (kappa 0.71 - 0.79) and fair-moderate between radiologists (kappa 0.34 - 0.42). WebThe most important scans are T1 scans with contrast and T2/FLAIR scans. Privacy WMH'S AND SEVERE AND RESISTANT DEPRESSION, The clinical importance of white matter hyperintensities, White matter hyperintensity progression and late-life depression outcomes, White matter hyperintensity accumulation during treatment of late-life depression, melancholic depression and association of WMHs with structural melancholia, neuropsychiatric aspects of Multiple Sclerosis. The periventricular WMHs were defined as T2/FLAIR signal alterations in direct contact with the ventricular system. Material/methods: Cerebral MRI results of 246 patients (134 females, 112 males), aged 2 -79 years, were a focus of T2 hyperINTENSITY means that the signal from that area has different tissue characteristics compared to normal brian tissue. Copyright 2000-2022 IGNACIO GARCIA, LLC.All rights reserved Web master Iggy Garciamandriotti@yahoo.com Columbus, Ohio Last modified May, 2021 Hosted by GVO, USC TITLE 42 CHAPTER 21B 2000BB1 USC TITLE 42 CHAPTER 21C 2000CC IRS PUBLICATION 517, Welcome to Iggy Garcia, The Naked Shaman Podcast, where amazing things happen. No explicit astrocytosis or clasmatodendrosis was present in the haematoxylin-eosin-stained slides. 2023 BioMed Central Ltd unless otherwise stated. Periventricular WMHs were scored as follows: 0, absent; 1, pencil lines and/or caps; 2, smooth haloes; and 3, irregular. It helps in accurately diagnosing and assessing the diseases., On the other hand, the wide-bore MRI scanner also provides accurate and high-quality images. If you have a subscription you may use the login form below to view the article. a focus of T2 hyperINTENSITY means that the signal from that area has different tissue characteristics compared to normal brian tissue. Impression: There are scattered foci of T2/FLAIR hyperintensity within the periventricular, deep and subcortical white matter. It also assesses the structure of the heart and aorta., The term MRI hyperintensity defines how components of the scan look. Deep WMHs were scored as follows: 0, absent; 1, punctate; 2, coalescing; and 3, confluent. 10.1016/S0140-6736(00)02604-0, Article Google Scholar, Ylikoski A, Erkinjuntti T, Raininko R, Sarna S, Sulkava R, Tilvis R: White matter hyperintensities on MRI in the neurologically nondiseased elderly. Neurology 1996, 47: 11131124. T2 hyperintensities (lesions). WebWhite matter changes are visible on magnetic resonance imaging (MRI) as lesions. We report the radiologic-histopathologic concordance between T2/FLAIR WMHs and neuropathologically confirmed demyelination in the periventricular, perivascular and deep white matter (WM) areas.