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Updated: Feb 25, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Pre- and Postcontrast 3D Double Inversion Recovery Sequence in Multiple Sclerosis: A Simple and Effective MR Imaging
P Eichinger1, J S Kirschke1, M-M Hoshi2
1From the Department of Neuroradiology (P.E., J.S.K., C.Z., I.R.).
Background And Purpose:
The double inversion recovery sequence is known to be very sensitive and specific for MS-related lesions. Our aim was to compare the sensitivity of pre- and postcontrast images of 3D double inversion recovery and conventional 3D T1-weighted images for the detection of contrast-enhancing MS-related lesions in the brain to analyze whether double inversion recovery could be as effective as T1WI.
Materials And Methods:
A postcontrast 3D double inversion recovery sequence was acquired in addition to the standard MR imaging protocol at 3T, including pre- and postcontrast 3D T1WI sequences as well as precontrast double inversion recovery of 45 consecutive patients with MS or clinically isolated syndrome between June and December 2013. Two neuroradiologists independently assessed precontrast, postcontrast, and subtraction images of double inversion recovery as well as T1WI to count the number of contrast-enhancing lesions. Afterward, a consensus reading was performed. Lin concordance was calculated between both radiologists, and differences in lesion detectability were assessed with the Student t test. Additionally, the contrast-to-noise ratio was calculated.
Results:
Significantly more contrast-enhancing lesions could be detected with double inversion recovery compared with T1WI (16%, 214 versus 185, P = .007). The concordance between both radiologists was almost perfect (ρc = 0.94 for T1WI and ρc = 0.98 for double inversion recovery, respectively). The contrast-to-noise ratio was significantly higher in double inversion recovery subtraction images compared with T1-weighted subtraction images (double inversion recovery, 14.3 ± 5.5; T1WI, 6.3 ± 7.1; P < .001).
Conclusions:
Pre- and postcontrast double inversion recovery enables better detection of contrast-enhancing lesions in MS in the brain compared with T1WI and may be considered an alternative to the standard MR imaging protocol.
Insights
Double inversion recovery (DIR) MRI sequences detect more contrast-enhancing lesions in multiple sclerosis (MS) brain scans than standard T1-weighted images (T1WI). This advanced MRI technique offers improved sensitivity for MS lesion detection.
Area of Science:
- Radiology
- Neuroimaging
- Multiple Sclerosis Research
Background:
- Multiple Sclerosis (MS) diagnosis relies on detecting brain lesions.
- Contrast-enhancing lesions are key indicators of active MS.
- Standard MRI protocols use T1-weighted imaging (T1WI) for lesion detection.
Purpose of the Study:
- To compare the sensitivity of 3D double inversion recovery (DIR) with conventional 3D T1-weighted images (T1WI).
- To evaluate DIR's effectiveness in detecting contrast-enhancing MS lesions in the brain.
- To determine if DIR can serve as an alternative to T1WI in MS imaging.
Main Methods:
- Acquired pre- and postcontrast 3D DIR and 3D T1WI sequences at 3T.
- Two neuroradiologists independently assessed images from 45 MS patients.
- Calculated lesion counts, inter-reader concordance (Lin concordance), and contrast-to-noise ratio (CNR).
Main Results:
- DIR detected significantly more contrast-enhancing lesions (16% increase, 214 vs. 185 lesions; P = .007).
- Inter-reader concordance was nearly perfect for both DIR (ρc = 0.98) and T1WI (ρc = 0.94).
- DIR subtraction images showed significantly higher CNR than T1WI subtraction images (14.3 ± 5.5 vs. 6.3 ± 7.1; P < .001).
Conclusions:
- Pre- and postcontrast 3D DIR imaging enhances the detection of contrast-enhancing MS lesions in the brain.
- DIR demonstrates superior sensitivity and CNR compared to standard T1WI.
- DIR may be a valuable alternative or addition to current standard MRI protocols for MS assessment.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...