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An optimized MP2RAGE protocol for spinal cord imaging in multiple sclerosis.

Nico Papinutto1, William A Stern2, Simone Sacco2

  • 1From the Weill Institute for Neurosciences (N.P., W.A.S., S.S., I.P., B.A.C.C., S.L.H., R.G.H.), Department of Neurology, University of California, San Francisco, California, USA and Department of Brain and Behavioral Sciences (I.P.), University of Pavia, Pavia, Italy nico.papinutto@ucsf.edu.

AJNR. American Journal of Neuroradiology
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Summary

A new 3T MRI protocol using MP2RAGE imaging allows for rapid, precise assessment of spinal cord atrophy and lesion detection in multiple sclerosis (MS) patients. This efficient method aids in both clinical trials and patient care.

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Area of Science:

  • Neuroimaging
  • Quantitative MRI
  • Spinal Cord Imaging

Background:

  • Spinal cord atrophy assessment in MS is limited by lesions and scan time.
  • Current MRI methods struggle with accuracy due to these limitations.
  • Advanced techniques are needed for reliable atrophy estimation and lesion detection.

Purpose of the Study:

  • To develop and optimize a novel MP2RAGE MRI protocol for 3T scanners.
  • To achieve a fast acquisition suitable for simultaneous gray and white matter atrophy estimation.
  • To enable accurate lesion detection alongside atrophy measurements.

Main Methods:

  • Optimized MP2RAGE protocol using T1 mapping in MS patients.
  • Applied protocol to a cohort of 35 MS participants.
  • Compared lesion detection with MP2RAGE versus standard axial MEDIC sequence.
  • Assessed signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).

Main Results:

  • The MP2RAGE protocol provides clear gray/white matter and cord/CSF differentiation, even with lesions.
  • MP2RAGE demonstrated statistically superior lesion detection compared to MEDIC.
  • CNR was comparable to established protocols, crucial for atrophy quantification.

Conclusions:

  • A 3T spinal cord-optimized MP2RAGE protocol covers the cervical cord in ~5 minutes.
  • Offers high tissue CNR for accurate quantification and effective lesion detection.
  • Presents an efficient single MRI protocol for clinical research in MS.