Neuroradiology

, Volume 55, Issue 4, pp 431–439

Axial 3D gradient-echo imaging for improved multiple sclerosis lesion detection in the cervical spinal cord at 3T

  • Arzu Ozturk
  • Nafi Aygun
  • Seth A. Smith
  • Brian Caffo
  • Peter A. Calabresi
  • Daniel S. Reich
Diagnostic Neuroradiology

DOI: 10.1007/s00234-012-1118-5

Cite this article as:
Ozturk, A., Aygun, N., Smith, S.A. et al. Neuroradiology (2013) 55: 431. doi:10.1007/s00234-012-1118-5

Abstract

Introduction

In multiple sclerosis (MS), spinal cord imaging can help in diagnosis and follow-up evaluation. However, spinal cord magnetic resonance imaging (MRI) is technically challenging, and image quality, particularly in the axial plane, is typically poor compared to brain MRI. Because gradient-recalled echo (GRE) images might offer improved contrast resolution within the spinal cord at high magnetic field strength, both without and with a magnetization transfer prepulse, we compared them to T2-weighted fast-spin-echo (T2-FSE) images for the detection of MS lesions in the cervical cord at 3T.

Methods

On a clinical 3T MRI scanner, we studied 62 MS cases and 19 healthy volunteers. Axial 3D GRE sequences were performed without and with off-resonance radiofrequency irradiation. To mimic clinical practice, all images were evaluated in conjunction with linked images from a sagittal short tau inversion recovery scan, which is considered the gold standard for lesion detection in MS. Two experienced observers recorded image quality, location and size of focal lesions, atrophy, swelling, and diffuse signal abnormality independently at first and then in consensus.

Results

The number and volume of lesions detected with high confidence was more than three times as high on both GRE sequences compared to T2-FSE (p < 0.0001). Approximately 5 % of GRE scans were affected by artifacts that interfered with image interpretation, not significantly different from T2W-FSE.

Conclusions

Axial 3D GRE sequences are useful for MS lesion detection when compared to 2D T2-FSE sequences in the cervical spinal cord at 3T and should be considered when examining intramedullary spinal cord lesions.

Keywords

Multiple sclerosis Diagnostic imaging Magnetic resonance imaging Spinal cord Magnetization transfer contrast imaging 

Copyright information

© Springer-Verlag (outside the USA) 2012

Authors and Affiliations

  • Arzu Ozturk
    • 1
  • Nafi Aygun
    • 1
  • Seth A. Smith
    • 2
    • 3
    • 4
    • 5
    • 6
  • Brian Caffo
    • 7
  • Peter A. Calabresi
    • 8
  • Daniel S. Reich
    • 1
    • 7
    • 8
    • 9
  1. 1.Department of RadiologyJohns Hopkins UniversityBaltimoreUSA
  2. 2.F. M. Kirby Research Center for Functional Brain ImagingKennedy Krieger InstituteBaltimoreUSA
  3. 3.Department of Radiology and Radiological SciencesVanderbilt UniversityNashvilleUSA
  4. 4.Department of Biomedical EngineeringVanderbilt UniversityNashvilleUSA
  5. 5.Department of Physics and AstronomyVanderbilt UniversityNashvilleUSA
  6. 6.Institute of Imaging ScienceVanderbilt UniversityNashvilleUSA
  7. 7.Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  8. 8.Department of NeurologyJohns Hopkins UniversityBaltimoreUSA
  9. 9.Translational Neuroradiology Unit, National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaUSA

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