HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Geurts, J. J. G. Articles by Castelijns, J. A. Search for Related Content PubMed PubMed Citation Articles by Geurts, J. J. G. Articles by Castelijns, J. A.

Intracortical Lesions in Multiple Sclerosis: Improved Detection with 3D Double Inversion-Recovery MR Imaging¹

¹ From the Departments of Radiology (J.J.G.G., F.B., J.A.C.), Neurology (B.M.J.U., C.H.P.), and Physics and Medical Technology (P.J.W.P.), MR Center for MS Research, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. Received March 10, 2004; revision requested May 21; final revision received September 2; accepted September 29. J.J.G.G. supported by grant 00-427 from the Stichting MS Research, Voorschoten, the Netherlands. Address correspondence to J.J.G.G. (e-mail: j.geurts{at}vumc.nl).

PURPOSE: To prospectively compare the depiction of intracortical lesions by using multislab three-dimensional (3D) double inversion-recovery (DIR), multislab 3D fluid-attenuated inversion-recovery (FLAIR), and T2-weighted spin-echo (SE) magnetic resonance (MR) imaging in patients with multiple sclerosis.

MATERIALS AND METHODS: Local ethics review board approval and informed consent were obtained. Conventional T2-weighted SE and multislab 3D FLAIR and DIR images were acquired in 10 patients with multiple sclerosis (five women, five men) and 11 age-matched healthy control subjects (seven women, four men). Mean age was 40 years (range, 25–54 years) in patients and 34 years (range, 24–55 years) in control subjects. Lesions were classified according to seven anatomic regions: intracortical, mixed white matter–gray matter, juxtacortical, deep gray matter, periventricular white matter, deep white matter, and infratentorial lesions. The numbers of lesions per category were compared between techniques (Dunnett-corrected analysis of variance). Gain or loss (with 95% confidence intervals [CIs]) of numbers of lesions detected at 3D DIR imaging was calculated in comparison with those detected at T2-weighted SE and 3D FLAIR imaging.

RESULTS: Total number of lesions did not differ between 3D DIR and 3D FLAIR sequences, but the 3D DIR sequence showed a gain of 21% (95% CI: 4%, 41%) in comparison with the T2-weighted SE sequence. Because of high gray matter–white matter contrast, DIR images depicted more intracortical lesions (80 lesions in 10 patients) than both SE (10 lesions) and FLAIR (31 lesions) images; gains with DIR were 538% (95% CI: 191%, 1297%) and 152% (95% CI: 15%, 453%) compared with SE and FLAIR, respectively. Only four intracortical lesions were detected in control subjects. Also, DIR imaging enabled a better definition of mixed white matter–gray matter lesions because of greater contrast between the lesion and its surroundings.

CONCLUSION: MR imaging with 3D DIR enables increased intracortical lesion detection in the multiple sclerosis brain, as well as improved distinction between juxtacortical and white matter–gray matter lesions.

© RSNA, 2005

This article has been cited by other articles:

				M Calabrese, M Filippi, M Rovaris, V Bernardi, M Atzori, I Mattisi, A Favaretto, P Grossi, L Barachino, L Rinaldi, et al. Evidence for relative cortical sparing in benign multiple sclerosis: a longitudinal magnetic resonance imaging study Multiple Sclerosis, January 1, 2009; 15(1): 36 - 41. [Abstract] [PDF]

				B. Moraal, D. S. Meier, P. A. Poppe, J. J. G. Geurts, H. Vrenken, W. M. A. Jonker, D. L. Knol, R. A. van Schijndel, P. J. W. Pouwels, C. Pohl, et al. Subtraction MR Images in a Multiple Sclerosis Multicenter Clinical Trial Setting Radiology, November 26, 2008; (2008) 2501080480. [Abstract] [Full Text]

				F Nelson, A Poonawalla, P Hou, J. Wolinsky, and P. Narayana 3D MPRAGE improves classification of cortical lesions in multiple sclerosis Multiple Sclerosis, November 1, 2008; 14(9): 1214 - 1219. [Abstract] [PDF]

				N. L. Sicotte, K. C. Kern, B. S. Giesser, A. Arshanapalli, A. Schultz, M. Montag, H. Wang, and S. Y. Bookheimer Regional hippocampal atrophy in multiple sclerosis Brain, April 1, 2008; 131(4): 1134 - 1141. [Abstract] [Full Text] [PDF]

				L. K. Fisniku, P. A. Brex, D. R. Altmann, K. A. Miszkiel, C. E. Benton, R. Lanyon, A. J. Thompson, and D. H. Miller Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis Brain, March 1, 2008; 131(3): 808 - 817. [Abstract] [Full Text] [PDF]

				A. H. Poonawalla, K. M. Hasan, R. K. Gupta, C. W. Ahn, F. Nelson, J. S. Wolinsky, and P. A. Narayana Diffusion-Tensor MR Imaging of Cortical Lesions in Multiple Sclerosis: Initial Findings Radiology, March 1, 2008; 246(3): 880 - 886. [Abstract] [Full Text] [PDF]

				Y. Duan, P.G. Hildenbrand, M.P. Sampat, D.F. Tate, I. Csapo, B. Moraal, R. Bakshi, F. Barkhof, D.S. Meier, and C.R.G. Guttmann Segmentation of Subtraction Images for the Measurement of Lesion Change in Multiple Sclerosis AJNR Am. J. Neuroradiol., February 1, 2008; 29(2): 340 - 346. [Abstract] [Full Text] [PDF]

				F. Nelson, A.H. Poonawalla, P. Hou, F. Huang, J.S. Wolinsky, and P.A. Narayana Improved Identification of Intracortical Lesions in Multiple Sclerosis with Phase-Sensitive Inversion Recovery in Combination with Fast Double Inversion Recovery MR Imaging AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1645 - 1649. [Abstract] [Full Text] [PDF]

				M. Calabrese, N. De Stefano, M. Atzori, V. Bernardi, I. Mattisi, L. Barachino, A. Morra, L. Rinaldi, C. Romualdi, P. Perini, et al. Detection of Cortical Inflammatory Lesions by Double Inversion Recovery Magnetic Resonance Imaging in Patients With Multiple Sclerosis Arch Neurol, October 1, 2007; 64(10): 1416 - 1422. [Abstract] [Full Text] [PDF]

				M. P. Amato, E. Portaccio, B. Goretti, V. Zipoli, M. Battaglini, M. L. Bartolozzi, M. L. Stromillo, L. Guidi, G. Siracusa, S. Sorbi, et al. Association of Neocortical Volume Changes With Cognitive Deterioration in Relapsing-Remitting Multiple Sclerosis Arch Neurol, August 1, 2007; 64(8): 1157 - 1161. [Abstract] [Full Text] [PDF]

				H. Vrenken, P.J.W. Pouwels, S. Ropele, D.L. Knol, J.J.G. Geurts, C.H. Polman, F. Barkhof, and J.A. Castelijns Magnetization transfer ratio measurement in multiple sclerosis normal-appearing brain tissue: limited differences with controls but relationships with clinical and MR measures of disease Multiple Sclerosis, July 1, 2007; 13(6): 708 - 716. [Abstract] [PDF]

				R. Zivadinov Can imaging techniques measure neuroprotection and remyelination in multiple sclerosis? Neurology, May 29, 2007; 68(22_suppl_3): S72 - S82. [Abstract] [Full Text] [PDF]

				I. Pirko, C. F. Lucchinetti, S. Sriram, and R. Bakshi Gray matter involvement in multiple sclerosis Neurology, February 27, 2007; 68(9): 634 - 642. [Abstract] [Full Text] [PDF]

				A. Kangarlu, E.C. Bourekas, A. Ray-Chaudhury, and K.W. Rammohan Cerebral Cortical Lesions in Multiple Sclerosis Detected by MR Imaging at 8 Tesla AJNR Am. J. Neuroradiol., February 1, 2007; 28(2): 262 - 266. [Abstract] [Full Text] [PDF]

				M.P. Wattjes, G.G. Lutterbey, J. Gieseke, F. Traber, L. Klotz, S. Schmidt, and H.H. Schild Double Inversion Recovery Brain Imaging at 3T: Diagnostic Value in the Detection of Multiple Sclerosis Lesions AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 54 - 59. [Abstract] [Full Text] [PDF]

				P. J. W. Pouwels, J. P. A. Kuijer, J. P. Mugler III, C. R. G. Guttmann, and F. Barkhof Human Gray Matter: Feasibility of Single-Slab 3D Double Inversion-Recovery High-Spatial-Resolution MR Imaging Radiology, December 1, 2006; 241(3): 873 - 879. [Abstract] [Full Text] [PDF]

				F. Bagnato, J.A. Butman, S. Gupta, M. Calabrese, L. Pezawas, J.M. Ohayon, F. Tovar-Moll, M. Riva, M.M. Cao, S.L. Talagala, et al. In Vivo Detection of Cortical Plaques by MR Imaging in Patients with Multiple Sclerosis AJNR Am. J. Neuroradiol., November 1, 2006; 27(10): 2161 - 2167. [Abstract] [Full Text] [PDF]

				Z. Caramanos, S. Narayanan, and D. L. Arnold 1H-MRS quantification of tNA and tCr in patients with multiple sclerosis: a meta-analytic review Brain, November 1, 2005; 128(11): 2483 - 2506. [Abstract] [Full Text] [PDF]