Cervical Spinal Cord Lesions in Multiple Sclerosis: T1-weighted Inversion-Recovery MR Imaging with Phase-Sensitive Reconstruction

Abstract

This magnetic resonance (MR) imaging study was approved by the institutional review board and was HIPAA compliant. Written informed consent was obtained from all participants. The purpose of the study was to prospectively compare T1-weighted inversion recovery with short inversion time inversion recovery (STIR) and dual fast spin echo (FSE) for imaging cervical spinal cord lesions in patients with multiple sclerosis (MS). Twelve patients (eight men, four women; median age, 44 years) were imaged by using T1-weighted inversion recovery, STIR, and FSE. Contrast between lesions and normal cervical cord was measured for each sequence, and generalized estimating equation analysis was used to test statistical significance of the results. Normalized contrast between lesion and normal-appearing spinal cord was significantly higher for T1-weighted inversion recovery than for the other sequences (P < .0001). Use of phase-sensitive reconstruction improved lesion localization and boundary definition. These advantages of T1-weighted inversion recovery over STIR and dual-echo FSE suggest that it has potential in cervical spinal cord imaging of MS. (c) RSNA, 2007.

Proton Density MRI Increases Detection of Cervical Spinal Cord Multiple Sclerosis Lesions Compared with T2-Weighted Fast Spin-Echo

“…Most studies are designed to assess either dualecho (PD and T2-weighted) conventional spin-echo (SE) and dual-echo FSE or T2-FSE MR imaging against other novel sequences such as STIR. 8,13,17,19 Discordant study designs and variability in data presentation and analyses preclude a substantive and useful comparison of our findings with those in these alternate studies. However, T2-weighted imaging was consistently outperformed by alternate MR sequences in all of these studies.…”

“…However, T2-weighted imaging was consistently outperformed by alternate MR sequences in all of these studies. 8,13,17,19 Moreover, there are good histopathologic data to support the use of PD-weighted imaging. 20 A postmortem study of 19 patients with MS assessed the correlation between histopathology and 4.7T and 1T PD-SE MR imaging.…”

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

“…Highresolution axial PSIR and T2-weighted images in combination are sensitive for depicting and localizing cervical cord lesions, but the long acquisition times preclude their use in routine practice. 127 …”

Evaluation of Focal Cervical Spinal Cord Lesions in Multiple Sclerosis: Comparison of White Matter-Suppressed T1 Inversion Recovery Sequence versus Conventional STIR and Proton Density-Weighted Turbo Spin-Echo Sequences

“…In a smaller study population, the WM-suppressed T1 inversion recovery (WMS) sequence has shown improvement in lesion conspicuity over STIR and dual-echo fast spin-echo. 9 While the principles of the contrast mechanism on WMS are similar to those on STIR, the sequence parameters of WMS are optimized for better intramedullary imaging. In WMS, the section-selective inversion pulse is applied at 385 ms to suppress the background signal from white matter, whereas in STIR, it is applied at 160 ms to optimize fat suppression.…”