Is 3D MPRAGE better than the combination DIR/PSIR for cortical lesion detection at 3T MRI?

Nelson, Flavia; Poonawalla, Aziz H.; Datta, Sushmita; Wolinsky, Jerry S.; Narayana, Ponnada A.

doi:10.1016/j.msard.2013.10.002

Cited by 16 publications

(13 citation statements)

References 16 publications

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“…A possible critical point for CLs detection could be the lack of availability of DIR sequence in peripheral clinical centers and the moderate sensitivity of this sequence, as radiological and pathological comparison estimated an overall sensitivity of 17.1% . To overcome this issue, alternative sequences, such as phase sensitive inversion recovery (PSIR), DIR/PSIR combination, and MPRAGE, have been proposed. However, a standardized protocol for such an assessment is still lacking.…”

Section: Discussionmentioning

confidence: 99%

Brain and cord imaging features in neuromyelitis optica spectrum disorders

Cacciaguerra

Meani

Mesaroš

et al. 2019

Annals of Neurology

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Objectives: To validate imaging features able to discriminate neuromyelitis optica spectrum disorders from multiple sclerosis with conventional magnetic resonance imaging (MRI). Methods: In this cross-sectional study, brain and spinal cord scans were evaluated from 116 neuromyelitis optica spectrum disorder patients (98 seropositive and 18 seronegative) in chronic disease phase and 65 age-, sex-, and disease duration-matched multiple sclerosis patients. To identify independent predictors of neuromyelitis optica diagnosis, after assessing the prevalence of typical/atypical findings, the original cohort was 2:1 randomized in a training sample (where a multivariate logistic regression analysis was run) and a validation sample (where the performance of the selected variables was tested and validated). Results: Typical brain lesions occurred in 50.9% of neuromyelitis optica patients (18.1% brainstem periventricular/periaqueductal, 32.7% periependymal along lateral ventricles, 3.4% large hemispheric, 6.0% diencephalic, 4.3% corticospinal tract), 72.2% had spinal cord lesions (46.3% long transverse myelitis, 36.1% short transverse myelitis), 37.1% satisfied 2010 McDonald criteria, and none had cortical lesions. Fulfillment of at least 2 of 5 of absence of juxtacortical/cortical lesions, absence of periventricular lesions, absence of Dawson fingers, presence of long transverse myelitis, and presence of periependymal lesions along lateral ventricles discriminated neuromyelitis optica patients in both training (sensitivity = 0.92, 95% confidence interval [CI] = 0.84-0.97; specificity = 0.91, 95% CI = 0.78-0.97) and validation samples (sensitivity = 0.82, 95% CI = 0.66-0.92; specificity = 0.91, 95% CI = 0.71-0.99). MRI findings and criteria performance were similar irrespective of serostatus. Interpretation: Although up to 50% of neuromyelitis optica patients have no typical lesions and a relatively high percentage of them satisfy multiple sclerosis criteria, several easily applicable imaging features can help to distinguish neuromyelitis optica from multiple sclerosis.Additional supporting information can be found in the online version of this article.

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Section: Discussionmentioning

confidence: 99%

Brain and cord imaging features in neuromyelitis optica spectrum disorders

Cacciaguerra

Meani

Mesaroš

et al. 2019

Annals of Neurology

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“…Combining different sequences, as performed for the criterion standard, was subjectively the preferred approach by the raters in the current study to accurately delineate cortical involvement, which supports previously proposed multimodal reading protocol approaches. 4,[29][30][31] Synthetic MR imaging has previously been shown to provide proton-density-, T1-, and T2-weightings in diagnostic quality (as illustrated in the On-line Figure) [13][14][15] as well as automatic volumetrics, 13 with a single acquisition. The image quality of synthetic FLAIR images has, however, been shown to be hampered by artifacts.…”

Section: Discussionmentioning

confidence: 99%

Detection of Leukocortical Lesions in Multiple Sclerosis and Their Association with Physical and Cognitive Impairment: A Comparison of Conventional and Synthetic Phase-Sensitive Inversion Recovery MRI

Forslin¹,

Bergendal²,

Hashim³

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Cortical lesions are common in multiple sclerosis and are included in the latest diagnostic criteria. The limited sensitivity of cortical MS lesions on conventional MR imaging can be improved by phase-sensitive inversion recovery. Synthetic MR imaging could provide phase-sensitive inversion recovery without additional scanning, but the use of synthetic phase-sensitive inversion recovery remains to be validated. We aimed to compare the ability and clinical value of detecting leukocortical lesions with conventional and synthetic phase-sensitive inversion recovery in MS. MATERIALS AND METHODS: Twenty-one patients with MS prospectively underwent conventional and synthetic phase-sensitive inversion recovery, 3D T1-weighted, and T2 FLAIR imaging. Two neuroradiologists independently performed blinded phase-sensitive inversion recovery lesion assessments; a consensus rating with all sequences was considered the criterion standard. Lesion volumes were segmented. All participants underwent standardized cognitive and physical examinations and Fatigue Severity Scale assessment. Results were analyzed with multiple linear regressions. RESULTS: Interrater and criterion standard agreement for leukocortical lesions was excellent for both conventional and synthetic phase-sensitive inversion recovery (intraclass correlation coefficient ϭ 0.79-0.97). Leukocortical lesion volumes for both sequences were associated with lower information-processing speed (P Յ .01) and verbal fluency (P Յ .02). Both phase-sensitive inversion recovery sequences showed a positive effect on the association when combining volumes of leukocortical lesions and white matter lesions with information-processing speed (P Յ .005) and verbal fluency (P Յ .03). No associations were found between leukocortical lesion volumes and physical disability or fatigue. CONCLUSIONS: Synthetic and conventional phase-sensitive inversion recovery have a sensitivity similar to that of leukocortical MS lesions. The detected leukocortical lesions are associated with cognitive dysfunction and thus provide clinically relevant information, which encourages assessment of cortical MS involvement at conventional field strengths. ABBREVIATIONS: DIR ϭ double inversion recovery; EDSS ϭ Expanded Disability Status Scale; ICC ϭ intraclass correlation coefficient; LCL ϭ leukocortical lesions; PSIR ϭ phase-sensitive inversion recovery; R 1 ϭ longitudinal relaxation rate; R 2 ϭ transverse relaxation rate

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“…Because of sample size and the restricted range of employment impairment, there may have been limited power to detect the full extent of MRI relationships. It would be of interest for future studies to test whether other aspects of MRI-defined involvement in MS, such as spinal cord [ 36 – 41 ], cortical [ 42 , 43 ], and diffuse cerebral damage [ 44 – 46 ], are related to productivity and whether MRI findings predict longitudinal change of employment status. Destructive effects of lesions may be particularly prominent using ultra-high-field strength MRI [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Brain MRI lesions and atrophy are associated with employment status in patients with multiple sclerosis

et al. 2015

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Multiple sclerosis (MS) commonly affects occupational function. We investigated the link between brain MRI and employment status. Patients with MS (n = 100) completed a Work Productivity and Activity Impairment (WPAI) (general health version) survey measuring employment status, absenteeism, presenteeism, and overall work and daily activity impairment. Patients “working for pay” were considered employed; “temporarily not working but looking for work,” “not working or looking for work due to age,” and “not working or looking for work due to disability” were considered not employed. Brain MRI T1 hypointense (T1LV) and T2 hyperintense (T2LV) lesion volumes were quantified. To assess lesional destructive capability, we calculated each subject’s ratio of T1LV to T2LV (T1/T2). Normalized brain parenchymal volume (BPV) assessed brain atrophy. The mean (SD) age was 45.5 (9.7) years; disease duration was 12.1 (8.1) years; 75 % were women, 76 % were relapsing-remitting, and 76 % were employed. T1LV, T1/T2, Expanded Disability Status Scale (EDSS) scores, and activity impairment were lower and BPV was higher in the employed vs. not employed group (Wilcoxon tests, p < 0.05). Age, disease duration, MS clinical subtype, and T2LV did not differ between groups (p > 0.05). In multivariable logistic regression modeling, adjusting for age, sex, and disease duration, higher T1LV predicted a lower chance of employment (p < 0.05). Pearson correlations showed that EDSS was associated with activity impairment (p < 0.05). Disease duration, age, and MRI measures were not correlated with activity impairment or other WPAI outcomes (p > 0.05). We report a link between brain atrophy and lesions, particularly lesions with destructive potential, to MS employment status.

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Is 3D MPRAGE better than the combination DIR/PSIR for cortical lesion detection at 3T MRI?

Cited by 16 publications

References 16 publications

Brain and cord imaging features in neuromyelitis optica spectrum disorders

Brain and cord imaging features in neuromyelitis optica spectrum disorders

Detection of Leukocortical Lesions in Multiple Sclerosis and Their Association with Physical and Cognitive Impairment: A Comparison of Conventional and Synthetic Phase-Sensitive Inversion Recovery MRI

Brain MRI lesions and atrophy are associated with employment status in patients with multiple sclerosis

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