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Updated: Sep 29, 2025

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
08:51

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla

Published on: February 19, 2021

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Contrast-enhanced double inversion recovery sequence for patients with multiple sclerosis: feasibility of subtraction

Noriaki Tomura1, Toshiyuki Saginoya1, Takashi Sanpei1

  • 1Department of Neuroradiology, Radiology and Neurology, 13704Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan.

Acta Radiologica (Stockholm, Sweden : 1987)
|March 21, 2022
PubMed
Abstract

Insights

Subtracted double inversion recovery (DIR) magnetic resonance (MR) imaging significantly improves visualization of multiple sclerosis (MS) lesions compared to standard contrast-enhanced T1-weighted (CE-T1W) scans. This technique offers superior contrast enhancement for MS lesions.

Area of Science:

  • Radiology
  • Neuroimaging
  • Multiple Sclerosis Research

Background:

  • Limited studies explored post-contrast double inversion recovery (DIR) MR sequences for multiple sclerosis (MS) due to potential signal loss in enhancing lesions.
  • Enhancing MS lesions are critical markers of disease activity.

Purpose of the Study:

  • To compare the efficacy of subtracted DIR images (pre-contrast minus post-contrast) with conventional contrast-enhanced T1-weighted (CE-T1W) images in depicting MS lesion contrast enhancement.
  • To evaluate the diagnostic performance of a novel DIR subtraction technique for MS lesion detection.

Main Methods:

  • A study included 27 patients with MS.
  • Two neuroradiologists assessed CE-T1W and subtracted DIR images using a 1-5 scoring scale.
  • Interrater agreement was measured using kappa (κ) coefficients, and signal-to-noise ratio (SNR) and contrast-noise-ratio (CNR) were compared.

Main Results:

  • Subtracted DIR images received significantly higher scores (mean 4.4-4.7) than CE-T1W images (mean 2.1-2.4) (P < 0.001).
  • While CE-T1W had higher SNR (24.8), DIR subtraction demonstrated significantly superior CNR (326.4) compared to CE-T1W (0.8) (P < 0.001).
  • Interrater agreement was good for both methods (κ=0.84 for CE-T1W, κ=0.72 for DIR subtraction).

Conclusions:

  • Subtracted DIR imaging provides more pronounced contrast enhancement of MS lesions than conventional CE-T1W imaging.
  • This technique holds promise for improved detection and monitoring of MS activity.
Keywords:
Magnetic resonance imagingadultsbrain/brain stemimaging sequencesintravenous contrast agents

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