Improved imaging of the spinal cord in multiple sclerosis using three-dimensional fast spin echo

Area of Science:

• Radiology
• Neurology
• Medical Imaging

Background:

• Multiple sclerosis (MS) diagnosis relies on detecting lesions in the central nervous system.
• Spinal cord lesions are crucial for diagnosis and prognosis in MS.
• Current imaging techniques may miss or underestimate the extent of spinal cord lesions.

Purpose of the Study:

• To evaluate a novel three-dimensional fast spin echo (3D FSE) sequence for spinal cord imaging in multiple sclerosis.
• To compare the lesion detection and characterization capabilities of 3D FSE with standard two-dimensional FSE (2D FSE).

Main Methods:

• A new 3D FSE sequence was assessed in ten patients with clinically definite multiple sclerosis and ten healthy controls.
• The 3D FSE sequence was compared against the standard 2D FSE sequence in the same patients.
• Lesion counts and lesion length measurements were analyzed statistically.

Main Results:

• The 3D FSE sequence identified significantly more focal lesions (53) compared to the 2D FSE sequence (29) in MS patients (P = 0.05).
• No lesions were detected in the control group using either sequence.
• Lesions measured significantly shorter on 3D FSE (1.36 mm) than on 2D FSE (2.0 mm), potentially due to improved resolution and detection of smaller or separated lesions.

Conclusions:

• The 3D FSE sequence demonstrates superior sensitivity for detecting spinal cord lesions in multiple sclerosis compared to 2D FSE.
• The improved detection may stem from the thinner slices and better spatial resolution of the 3D FSE technique.
• This novel 3D FSE sequence holds significant promise for enhancing spinal cord imaging in multiple sclerosis management.