A 45-year-old patient presents with new-onset seizures. An MRI brain is performed. Which MRI sequence is most sensitive for detecting periventricular demyelinating plaques, such as those seen in multiple sclerosis, by nulling the signal from cerebrospinal fluid (CSF)?

Explanation

FLAIR (Fluid-Attenuated Inversion Recovery) is an inversion recovery sequence that nulls the signal from free water, such as CSF. This makes periventricular and juxtacortical lesions, which are often hyperintense on T2-weighted images, much more conspicuous against the dark CSF background. It is particularly useful for detecting demyelinating plaques in multiple sclerosis, subarachnoid hemorrhage, and periventricular edema.