SCI and mimics in SCD. (A) Axial (left) and coronal fluid-attenuated inversion recovery (FLAIR) images illustrate a qualifying silent cerebral infarct in the left parietal lobe (white arrows). An infarct-like lesion was defined as an MRI signal abnormality that was at least 3 mm in 1 dimension and that was visible in 2 planes on FLAIR images or similar image with 3D FLAIR sequence (not shown) and documented neurological examination performed by a neurologist demonstrating that the participant has a normal neurologic examination or an abnormality on examination that could not be explained by the location of the brain lesion(s). (B) Axial FLAIR (left), T2-weighted (middle), and T1-weighted (right) images of the same lesion demonstrate that the FLAIR sequence is better for the identification of SCIs (green circles). (C) Axial FLAIR images show that higher magnet strength (3.0 Tesla) improves image quality and identification of subtle lesions only seen at 3.0 Tesla (arrowhead). More obvious lesions are visible at 1.5 Tesla and 3.0 Tesla (arrows). (D) Linear and punctate T2 hyperintensities that suppress on FLAIR are consistent with prominent perivascular spaces (Virchow-Robin spaces). (E) Terminal zones of myelination on T2-weighted images. Axial FLAIR and T2-weighted images show ill-defined symmetrical T2-weighted hyperintensity in the deep parietal white matter. The T2-weighted image on the right illustrates that there are well-defined linear perivascular spaces extending throughout the area of subtle hyperintensity (green arrows). (F) Axial FLAIR images demonstrate a case of white matter injury in a premature infant (periventricular leukomalacia) that can mimic a SCI because of the increased signal on FLAIR (white arrows).