Related Experiment Videos
Suspected multiple sclerosis: MR imaging with a thin-section fast FLAIR pulse sequence
R H Hashemi1, W G Bradley, D Y Chen
1Long Beach Memorial MRI Center, Long Beach Memorial Medical Center, CA 90806, USA.
Purpose:
To compare thin-section, sagittal, fast fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) imaging with conventional axial spin-echo (SE) imaging for early detection of multiple sclerosis (MS) in the brain.
Materials And Methods:
Conventional 5-mm axial proton-density- and T2-weighted SE images and sagittal 2-mm fast FLAIR images of the brain in five healthy volunteers and 25 patients with clinically suspected MS were evaluated and graded as normal or as showing possible or probable MS in a double-blind study.
Results:
Fast FLAIR was judged better than SE in 37% of cases, equal to SE in 63%, and never worse than SE. In 43% of patients considered to have normal SE images, fast FLAIR images showed abnormalities consistent with MS. A subependymal striated appearance observed in several cases is believed to represent early inflammation and/or demyelination around subependymal veins in MS.
Conclusion:
Sagittal thin-section fast FLAIR is superior to conventional axial proton-density- and T2-weighted SE pulse sequences for detection of MS plaques in the brain.
Insights
Thin-section, sagittal, fast fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) imaging is superior for detecting early multiple sclerosis (MS) brain lesions compared to conventional spin-echo (SE) imaging.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
- Early and accurate detection of MS lesions is crucial for timely treatment and management.
- Conventional magnetic resonance imaging (MRI) techniques may have limitations in visualizing subtle early MS changes.
Purpose of the Study:
- To compare the efficacy of thin-section, sagittal fast fluid-attenuated inversion-recovery (FLAIR) MRI with conventional axial spin-echo (SE) MRI for the early detection of brain lesions in patients with suspected MS.
- To evaluate the diagnostic performance of fast FLAIR sequences in identifying MS plaques.
Main Methods:
- A double-blind study was conducted involving five healthy volunteers and 25 patients with clinically suspected MS.
- Brain imaging was performed using conventional 5-mm axial proton-density- and T2-weighted SE sequences and sagittal 2-mm fast FLAIR sequences.
- Images were independently graded by radiologists as normal or showing possible/probable MS.
Main Results:
- Fast FLAIR imaging was rated as better than SE in 37% of cases and equal in 63%, with SE never being superior.
- Abnormalities consistent with MS were detected by fast FLAIR in 43% of patients whose SE images were considered normal.
- A characteristic subependymal striated appearance, potentially indicating early inflammation or demyelination around subependymal veins, was observed in several MS cases.
Conclusions:
- Sagittal thin-section fast FLAIR MRI is superior to conventional axial proton-density- and T2-weighted SE pulse sequences for detecting MS plaques in the brain.
- Fast FLAIR imaging offers improved sensitivity for identifying early and subtle MS lesions.
- The findings support the use of fast FLAIR as a valuable tool in the early diagnosis of multiple sclerosis.