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

  • Diagnostic Neuroradiology
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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.

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Acknowledgments

We thank Terri Brawner, Jonathan Farrell, Eliza Gordon-Lipkin, Kathleen Kahl, Ivana Kusevic, and Peter van Zijl for assistance with data collection, and Govind Nair and Jiwon Oh for critical comments on the manuscript. Funding sources include NIH grants P41RR015241 and K99NS064098; National Multiple Sclerosis Society grants CA1029A2 and TR3760A3; and the Nancy Davis Center without Walls. Dr. Reich is supported by the Intramural Research Program of NINDS.

Conflict of interest

We declare that we have no conflict of interest.

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Author notes

  1. Seth A. Smith

    Present address: Institute of Imaging Science, Vanderbilt University, 1161 21st Ave S, MCN-AAA3111, Nashville, TN, 37232, USA

Authors and Affiliations

  1. Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD, 21287, USA

    Arzu Ozturk, Nafi Aygun & Daniel S. Reich

  2. F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD, 21205, USA

    Seth A. Smith

  3. Department of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Ave S, MCN-AAA3111, Nashville, TN, 37232, USA

    Seth A. Smith

  4. Department of Biomedical Engineering, Vanderbilt University, 1161 21st Ave S, MCN-AAA3111, Nashville, TN, 37232, USA

    Seth A. Smith

  5. Department of Physics and Astronomy, Vanderbilt University, 1161 21st Ave S, MCN-AAA3111, Nashville, TN, 37232, USA

    Seth A. Smith

  6. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA

    Brian Caffo & Daniel S. Reich

  7. Department of Neurology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD, 21287, USA

    Peter A. Calabresi & Daniel S. Reich

  8. Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bldg 10, Rm 5C103; 10 Center Drive, MSC 1400, Bethesda, MD, 20892, USA

    Daniel S. Reich

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  1. Arzu Ozturk
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Correspondence to Daniel S. Reich.

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Ozturk, A., Aygun, N., Smith, S.A. et al. Axial 3D gradient-echo imaging for improved multiple sclerosis lesion detection in the cervical spinal cord at 3T. Neuroradiology 55, 431–439 (2013). https://doi.org/10.1007/s00234-012-1118-5

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