Hyperintensity is a term used to describe how the part of an image looks on MRI scan. To get a good look at brain tissue which differs from surrounding tissue, there are a variety of sequences used (ie. T1, T2 or FLAIR) which highlight or suppress types of tissue so that abnormalities can be seen.
Hyperintensity on a T2 sequence basically means that the brain tissue in that particular spot differs from the rest of the brain. A bright spot on T2 is nonspecific by itself and must be interpreted within clinical context (symptoms, why you had the MRI done in the first place, etc). T2 hyperintensities may occur in demyelinating diseases such as multiple sclerosis , vasculitis (inflammation of the arteries in the brain), lyme disease - anything with a high water or protein content will tend to appear very bright on the T2 sequence.
The FLAIR sequence is used to suppress the hyperintense signal produced by water (or cerebrospinal fluid) in the brain. This is especially helpful when looking for lesions around the brain ventricles (which contain cerebrospinal fluid).
When we're talking about hyperintensities as seen on MRI in the context of MS, we are talking about lesions .
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