Related Experiment Video
Updated: Jan 5, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
3D PSIR MRI at 3 Tesla improves detection of spinal cord lesions in multiple sclerosis
S Mirafzal1, A Goujon1, R Deschamps2
1Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, Paris, France.
Background:
Spinal imaging in multiple sclerosis remains challenging because of its small size and numerous artifacts.
Objective:
To compare 3D Phase-Sensitive Inversion Recovery (PSIR) to a conventional dataset of 3D Short Tau Inversion Recovery (STIR) and T2-weighted imaging at 3 Tesla to detect multiple sclerosis spinal cord lesions.
Methods:
This prospective single-center study was approved by a national research ethics board and included 54 patients (median age 44) enrolled from December 2016 to August 2018. Two neuroradiologists individually analyzed the two datasets separately and in random order. Discrepancies were resolved by consensus with a third neuroradiologist. The primary judgment criterion was the number of spinal cord lesions. Secondary judgment criteria included location of the lesions, reader-reported confidence and conspicuity assessed with the lesion-to-cord contrast ratio (LCCR).
Results:
3D PSIR detected significantly more lesions than the conventional dataset (371 versus 173, respectively, p < 0.05). Seven patients had no detected lesion with the conventional dataset, whereas 3D PSIR detected at least one lesion. LCCR mean reader-reported confidence (p < 0.001) and inter-observer agreement were higher using 3D PSIR.
Conclusions:
3D PSIR significantly improved overall spinal cord lesion detection in MS patients, with higher reader-reported confidence, higher lesion contrast, and higher inter-reader agreement.
Insights
Three-dimensional Phase-Sensitive Inversion Recovery (3D PSIR) MRI significantly enhances spinal cord lesion detection in multiple sclerosis (MS) patients compared to conventional imaging. This advanced technique offers improved confidence and accuracy for diagnosing MS spinal cord lesions.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Spinal imaging for multiple sclerosis (MS) presents challenges due to small lesion size and image artifacts.
- Accurate detection of spinal cord lesions is crucial for MS diagnosis and management.
Purpose of the Study:
- To compare the efficacy of 3D Phase-Sensitive Inversion Recovery (3D PSIR) with conventional 3D Short Tau Inversion Recovery (STIR) and T2-weighted imaging at 3 Tesla for detecting MS spinal cord lesions.
- To evaluate lesion conspicuity and reader confidence using different MRI sequences.
Main Methods:
- A prospective study involving 54 MS patients analyzed two imaging datasets: 3D PSIR and conventional (3D STIR/T2-weighted).
- Two neuroradiologists independently assessed lesion counts, locations, and confidence levels.
- Lesion-to-cord contrast ratio (LCCR) was used to assess conspicuity.
Main Results:
- 3D PSIR detected significantly more spinal cord lesions (371) compared to the conventional dataset (173).
- Seven patients with no lesions on conventional imaging showed lesions on 3D PSIR.
- Higher reader confidence, conspicuity (LCCR), and inter-observer agreement were observed with 3D PSIR.
Conclusions:
- 3D PSIR offers a significant improvement in detecting spinal cord lesions in MS patients.
- The technique enhances diagnostic accuracy through increased lesion detection, higher reader confidence, and better inter-reader agreement.
