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Updated: Jun 3, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Double inversion recovery magnetic resonance imaging at 3 T: diagnostic value in hippocampal sclerosis
Qiong Li1, Quan Zhang, Haoran Sun
1Department of Radiology, General Hospital of Tianjin Medical University, Tianjin, China.
Objective:
The objective of the study was to examine the utility of double inversion recovery (DIR) magnetic resonance imaging (MRI) using a 3-T magnetic resonance imager in the preoperative evaluation of hippocampal sclerosis (HS) in patients with mesial temporal lobe epilepsy.
Methods:
This retrospective study had institutional review board approval, and informed consent was obtained. Twelve patients with unilateral HS and 12 age-matched healthy control subjects were included. Imaging was performed using DIR, fluid-attenuated inversion recovery (FLAIR), and T2-weighted turbo spin-echo (T2 TSE) sequences vertical to the hippocampal axis. Quantitative assessment for hippocampus of the patients and control subjects was determined. Regions of interest (ROIs) were placed on bilateral hippocampi, and signal intensity was measured. The signal-to-noise ratio (SNR) of ipsilateral hippocampus, contrast ratio of ipsilateral-to-contralateral side, contrast-to-noise ratio (CNR), and asymmetry index of bilateral hippocampi were calculated and compared among the 3 sequences. Statistical analyses were performed with 1-way analysis of variance and Student t test.
Results:
On DIR images, HS demonstrated extremely high signal intensity. The hippocampi ipsilateral to the seizure focus showed significantly increased signal intensity, as compared with contralateral hippocampi and healthy subjects (F = 47.876, P < 0.001). The higher SNR of ipsilateral hippocampus on DIR was significant compared with the FLAIR and T2 TSE (P < 0.01). The CNR of bilateral hippocampi on DIR was also significantly higher than that on the FLAIR and T2 TSE (P < 0.01). However, compared with the FLAIR, no significant differences of contrast ratio and asymmetry index between bilateral hippocampi were observed on DIR.
Conclusions:
Double inversion recovery brain imaging reveals characteristically extremely high signal intensity of hippocampus in patients with HS. Double inversion recovery images can describe HS with high SNR and CNR superior to conventional magnetic resonance sequences and can be valuable for the diagnosis of HS.
Insights
Double inversion recovery (DIR) magnetic resonance imaging (MRI) enhances visualization of hippocampal sclerosis (HS) in mesial temporal lobe epilepsy. DIR offers superior signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for diagnosing HS compared to conventional MRI sequences.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Mesial temporal lobe epilepsy (MTLE) is often associated with hippocampal sclerosis (HS).
- Accurate preoperative diagnosis of HS is crucial for surgical planning in MTLE.
- Conventional MRI sequences may have limitations in detecting subtle HS.
Purpose of the Study:
- To evaluate the effectiveness of double inversion recovery (DIR) magnetic resonance imaging (MRI) at 3-Tesla for preoperative assessment of HS.
- To compare the diagnostic performance of DIR with fluid-attenuated inversion recovery (FLAIR) and T2-weighted turbo spin-echo (T2 TSE) sequences.
Main Methods:
- Retrospective analysis of 12 patients with unilateral HS and 12 healthy controls.
- Acquisition of MRI scans using DIR, FLAIR, and T2 TSE sequences.
- Quantitative analysis of signal intensity, signal-to-noise ratio (SNR), contrast ratio, contrast-to-noise ratio (CNR), and asymmetry index in the hippocampi.
Main Results:
- DIR imaging demonstrated significantly higher signal intensity in hippocampi affected by HS compared to controls and contralateral hippocampi.
- DIR provided superior SNR and CNR for the ipsilateral hippocampus compared to FLAIR and T2 TSE sequences.
- No significant differences in contrast ratio or asymmetry index were observed between DIR and FLAIR.
Conclusions:
- DIR brain imaging effectively visualizes the characteristic high signal intensity of HS in the hippocampus.
- DIR sequences offer improved SNR and CNR, surpassing conventional MRI sequences for HS diagnosis.
- DIR MRI is a valuable tool for the preoperative evaluation and diagnosis of HS in patients with MTLE.
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