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Updated: Mar 23, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Phase-Sensitive Inversion-Recovery MRI Improves Longitudinal Cortical Lesion Detection in Progressive MS
Asaff Harel1, Antonia Ceccarelli1, Colleen Farrell1,2
1Department of Neurology, Mount Sinai Hospital, New York, New York, United States of America.
Abstract:
Previous studies comparing phase sensitive inversion recovery (PSIR) to double inversion recovery (DIR) have demonstrated that use of PSIR improves cross-sectional in vivo detection of cortical lesions (CL) in multiple sclerosis. We studied the utility of PSIR in detection/characterization of accrual of CL over time in a 1-year longitudinal study in primary progressive multiple sclerosis (PPMS) compared to DIR. PSIR and DIR images were acquired with 3T magnetic resonance imaging (MRI) in 25 patients with PPMS and 19 healthy controls at baseline, and after 1 year in 20 patients with PPMS. CL were classified as intracortical, leucocortical or juxtacortical. Lesion counts and volumes were calculated for both time points from both sequences and compared. Correlations with measures of physical and cognitive disability were determined as well as new CL counts and volumes. Compared to DIR, PSIR led to detection of a higher number of CL involving a larger proportion of patients with PPMS both cross-sectionally (p = 0.006, 88%) and longitudinally (p = 0.007, 95%), and led to the reclassification of a third of CL seen on DIR at each time point. Interestingly, PSIR was more sensitive to new CL accumulation over time compared to DIR. PSIR is a promising technique to monitor cortical damage and disease progression in patients with PPMS over a short-term follow-up.
Insights
Phase sensitive inversion recovery (PSIR) magnetic resonance imaging (MRI) detects more cortical lesions (CL) in primary progressive multiple sclerosis (PPMS) than double inversion recovery (DIR). PSIR is promising for monitoring disease progression in PPMS.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Cortical lesions (CL) are key markers of disease severity in multiple sclerosis (MS).
- Previous studies suggest phase sensitive inversion recovery (PSIR) MRI may offer superior detection of CL compared to double inversion recovery (DIR).
- Longitudinal assessment of CL accrual is crucial for understanding disease progression in primary progressive multiple sclerosis (PPMS).
Purpose of the Study:
- To evaluate the utility of PSIR compared to DIR for detecting and characterizing the accrual of CL over a 1-year period in patients with PPMS.
- To assess the sensitivity of PSIR in identifying new CL formation and changes in lesion burden over time.
- To correlate MRI findings with physical and cognitive disability measures.
Main Methods:
- A 1-year longitudinal study involving 25 patients with PPMS and 19 healthy controls.
- 3T magnetic resonance imaging (MRI) using both PSIR and DIR sequences at baseline and 1-year follow-up (20 PPMS patients).
- Classification of CL (intracortical, leucocortical, juxtacortical), calculation of lesion counts and volumes, and correlation with disability measures.
Main Results:
- PSIR detected a significantly higher number of CL in a greater proportion of PPMS patients compared to DIR, both cross-sectionally (88%) and longitudinally (95%).
- PSIR led to the reclassification of approximately one-third of CL identified by DIR at each time point.
- PSIR demonstrated higher sensitivity to the detection of new CL accumulation over the 1-year follow-up period compared to DIR.
Conclusions:
- PSIR is a more sensitive MRI technique than DIR for detecting cortical lesions in patients with PPMS.
- PSIR shows promise for effectively monitoring cortical damage and disease progression in PPMS over short-term follow-up periods.
- The enhanced detection capabilities of PSIR may improve the assessment of disease activity and treatment response in PPMS.
