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Updated: Jul 23, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Clinical evaluation of white matter lesions on 3D inversion recovery ultrashort echo time MRI in multiple sclerosis
Sam Sedaghat1,2, Hyungseok Jang1, Yajun Ma1
1Department of Radiology, University of California, San Diego, CA, USA.
Background:
We clinically evaluated the quality of white matter lesions (WML) of the cerebrum on 3D inversion recovery ultrashort echo time (IR-UTE) magnetic resonance imaging (MRI) in multiple sclerosis (MS) patients.
Methods:
Forty-nine patients with MS were included in this study. A 3T MRI scanner was used. Two radiologists (readers) evaluated the quality of WML on IR-UTE images using a three-point Likert scale (1-good quality, 2-moderate quality, 3-insufficient quality). They also rated other WML-related factors potentially influencing WML quality using another three-point Likert scale (1-no/minor impact, 2-moderate impact, 3-high impact). Another reader rated the presence of WML on IR-UTE to evaluate the diagnostic value (right/false positive and false negative) of IR-UTE in detecting WML. Signal intensity ratios (SIRs) derived from WML signal intensities and WML sizes were also determined and analyzed.
Results:
Two hundred and seventy-five MS lesions were evaluated. 87% of the lesions were rated Likert 1 on IR-UTE (P<0.01). WML rated Likert 2 and 3 presented near the grey matter (GM) in 58% of the cases (n=21), with 14 lesions being ≤2 mm (P=0.03). 62.5% of the WML rated Likert 2/3 were in the temporal lobe (P=0.02). The mean SIR of WML on IR-UTE was 1.14±0.22, while the mean SIR on fluid-attenuated inversion recovery (FLAIR) was 6.97±1.88. There was no significant correlation of SIRs between IR-UTE and FLAIR (R=0.14, P=0.245). 92.4% of the WML were correctly detected on IR-UTE (n=254). 19 out of the 21 false positive/negative rated WML were located near the GM or in the temporal lobe. WML presented 7.7% smaller in mean on IR-UTE compared to FLAIR. Factors affecting WML quality with a moderate or high impact (Likert 2 and 3) were not found.
Conclusions:
Most WML are clearly detectable on IR-UTE sequences. The main limitations are WML in the temporal lobe and near the GM.
Insights
3D inversion recovery ultrashort echo time (IR-UTE) magnetic resonance imaging (MRI) effectively detects white matter lesions (WML) in multiple sclerosis (MS) patients. Limitations include WML detection near grey matter and in the temporal lobe.
Area of Science:
- Radiology
- Neuroimaging
- Medical Physics
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease characterized by white matter lesions (WML) in the brain.
- Accurate detection and characterization of WML are crucial for MS diagnosis and management.
- 3D inversion recovery ultrashort echo time (IR-UTE) magnetic resonance imaging (MRI) is a novel technique for brain imaging.
Purpose of the Study:
- To clinically evaluate the image quality of WML on 3D IR-UTE MRI.
- To assess the diagnostic performance of IR-UTE MRI in detecting WML in MS patients.
- To identify factors influencing WML quality and detection.
Main Methods:
- Forty-nine MS patients underwent 3T MRI, including 3D IR-UTE sequences.
- Two radiologists assessed WML quality using a Likert scale and evaluated factors impacting quality.
- A third reader assessed diagnostic performance (true/false positives/negatives), and signal intensity ratios (SIRs) were analyzed.
Main Results:
- 87% of evaluated WML were rated as good quality (Likert 1) on IR-UTE MRI.
- WML rated as moderate or insufficient quality were often located near grey matter (58%) or in the temporal lobe (62.5%).
- IR-UTE MRI correctly detected 92.4% of WML, with most false positives/negatives occurring near grey matter or in the temporal lobe.
Conclusions:
- 3D IR-UTE MRI demonstrates high quality and diagnostic value for detecting WML in MS.
- The primary limitations for WML detection using IR-UTE are their location near grey matter and within the temporal lobe.
