Pre- and Postcontrast 3D Double Inversion Recovery Sequence in Multiple Sclerosis: A Simple and Effective MR Imaging...

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.