SUMMARY:Texture analysis describes a variety of image-analysis techniques that quantify the variation in surface intensity or patterns, including some that are imperceptible to the human visual system. Texture analysis may be particularly well-suited for lesion segmentation and characterization and for the longitudinal monitoring of disease or recovery. We begin this review by outlining the general procedure for performing texture analysis, identifying some potential pitfalls and strategies for avoiding them. We then provide an overview of some intriguing neuro-MR imaging applications of texture analysis, particularly in the characterization of brain tumors, prediction of seizures in epilepsy, and a host of applications to MS.ABBREVIATIONS: ABSV ϭ absolute gradient value; AIS ϭ acute ischemic stroke; ANN ϭ artificial neural network; CIS ϭ clinically isolated syndrome; d ϭ distance; DCE ϭ dynamic contrastenhanced; FCD ϭ focal cortical dysplasia; FLAIR ϭ fluid-attenuated inversion recovery; f x ϭ second-order gray-level co-occurrence feature number "x"; GLCM ϭ gray-level co-occurrence matrix; GM ϭ gray matter; HT ϭ hemorrhagic transformation; LDA ϭ linear discriminant analysis; MGL ϭ mean gray level; MGR ϭ mean gradient; MS ϭ multiple sclerosis; MTR ϭ magnetization transfer ratio; NAWM ϭ normal-appearing white matter; N g ϭ number of gray levels; PCA ϭ principal components analysis; PPMS ϭ primary-progressive MS; RLM ϭ run-length matrix; ROC ϭ receiver-operator characteristic; ROI ϭ region of interest; RRMS ϭ relapsing-remitting MS; rtPA ϭ recombinant tissue plasminogen activator; SPMS ϭ secondary-progressive MS; SVM ϭ support vector machine; ϭ direction; VGL ϭ variance of gray levels; VGR ϭ variance gradient; WM ϭ white matter