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The value of chemical fat-saturation pulse added to T1-weighted spin-echo sequence in evaluating gadolinium-enhancing brain lesions in multiple sclerosis

Lesioni encefaliche con contrast-enhancement in pazienti affetti da sclerosi multipla: confronto tra sequenze spin-echo T1-pesate convenzionali e con saturazione spettrale del grasso

  • Neuroradiology Neuroradiologia
  • Published:
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Abstract

Purpose

This study was undertaken to assess the value of a chemical (spectral) fat-saturation (fat-sat) pulse added to a T1-weighted spin-echo sequence after intravenous administration of paramagnetic contrast agent in detecting enhancing lesions in multiple sclerosis.

Materials and methods

Twenty patients with relapsing-remitting multiple sclerosis underwent a brain 1.0-Tesla magnetic resonance (MR) scan with T1-weighted spin-echo sequences (24 contiguous para-axial slices with a thickness of 5 mm, pixel size 0.96 mm2, number of excitations 2, flip angle 90°) 5 min after intravenous injection of 0.1 mmol/kg of gadodiamide with and without fat-sat, acquired with randomised order of priority. Two readers counted by consensus the number of enhancing lesions and assigned a conspicuity score (low conspicuity=1; high conspicuity=2) to each enhancing lesion during a randomised reading without any visual comparison between the two corresponding images (with and without fat-sat) of the same patient. McNemar and Wilcoxon matched-pair signed-rank tests were used.

Results

Seventy-two enhancing lesions without fat-sat and 94 with fat-sat were detected; 22 lesions were visible only with fatsat, whereas no lesion was detected only without fat-sat (p<0.0001). The conspicuity score was 1.17±0.38 (mean±standard deviation) and 1.57±0.44, respectively (p<0.0001).

Conclusions

A fat-sat pulse added to a T1-weighted spin-echo sequence increases significantly the number and conspicuity of contrast-enhancing lesions in patients with relapsing-remitting multiple sclerosis.

Riassunto

Obiettivo

Confrontare sequenze spin-echo T1-pesate con e senza saturazione spettrale del grasso dopo somministrazione endovenosa di mezzo di contrasto paramagnetico per il riconoscimento di lesioni encefaliche con contrast-enhancement in pazienti affetti da sclerosi multipla.

Materiali e metodi

Venti pazienti affetti da sclerosi multipla intermittente-remittente sono stati sottoposti a RM encefalica a 1 Tesla con sequenze spin-echo T1-pesate (24 strati para-assiali contigui, spessore 5 mm, pixel 0,96 mm2, 2 eccitazioni, angolo di nutazione 90o) cinque minuti dopo iniezione endovenosa di 0,1 mmol/kg di gadodiamide, con e senza saturazione del grasso, acquisite in ordine temporale randomizzato. Due lettori in consenso hanno contato per entrambe le sequenze, con lettura randomizzata e senza confronto visuale tra le due immagini corrispondenti (con e senza saturazione del grasso) dello stesso paziente, il numero di lesioni focali con contrast-enhancement, assegnando a ciascuna un punteggio di cospicuità (bassa cospicuità=1; alta cospicuità=2). Per l’analisi statistica sono stati utilizzati i test di McNemar e Wilcoxon per ranghi per dati appaiati.

Risultati

Mentre la sequenza senza saturazione del grasso ha consentito il riconscimento di 72 lesioni, quella con saturazione del grasso ha consentito il riconoscimento di 94 lesioni: 22 lesioni erano quindi riconoscibili alla sola sequenza con saturazione del grasso (p<0,0001). Il punteggio di cospicuità è risultato pari a 1,17±0,38 (media±deviazione standard) e 1,57±0,44, rispettivamente (p<0,0001).

Conclusioni

L’integrazione di un preimpulso di saturazione del grasso in una sequenza spin-echo T1-pesata consente di ottenere un significativo incremento del numero e della cospicuità delle lesioni encefaliche con contrast-enhancement in pazienti affetti da sclerosi multipla intermittente-remittente.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, University of Milan School of Medicine, Via Morandi 30, I-20097, San Donato Milanese, Milan, Italy

    F. Sardanelli, A. Iozzelli, A. Fausto & A. Aliprandi

  2. Department of Radiology, Unit of Neuroradiology, the Biomedical Institute, Genoa, Italy

    S. Schiavoni

  3. Department of Radiology, Ophthalmology and Genetics, University of Genoa, Genoa, Italy

    G. L. Mancardi

  4. Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

    M. Filippi

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  1. F. Sardanelli
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  2. S. Schiavoni
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  3. A. Iozzelli
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  4. A. Fausto
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  5. A. Aliprandi
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  6. G. L. Mancardi
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  7. M. Filippi
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Correspondence to F. Sardanelli.

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Sardanelli, F., Schiavoni, S., Iozzelli, A. et al. The value of chemical fat-saturation pulse added to T1-weighted spin-echo sequence in evaluating gadolinium-enhancing brain lesions in multiple sclerosis. Radiol med 112, 1244–1251 (2007). https://doi.org/10.1007/s11547-007-0220-y

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