Added value of double inversion recovery magnetic resonance sequence in detection of cortical and white matter brain lesions in multiple sclerosis

Aims: The current work aimed to assess the diagnostically value of Magnetic Resonance Imaging (MRI) Double Inversion Recovery (DIR) sequence in diagnosing of multiple sclerosis. Methodology: This study conducted on (42 patients) from the Diagnostic Radiology and Medical Imaging Dep. at Tanta University Hospital in the period from March 2018 to December 2019. Results: In accordance to the total lesions loads, it was found that DIR was higher significantly than T2WI (P-value= 0.003 with a relative gaining of 22%), we found that double inversion recovery (DIR) sequence was higher significantly to FLAIR regarding the number of diagnosed lesions in 3 anatomical areas (Mixed W-GM, cortical and infra-tentorial) with relative gaining of 28%, 85% and 63% respectively. A non-significant change was found among the two sequences regarding peri-ventricular white matter, deep white matter and juxta-cortical lesions detecting. Conclusion: Conventionally MRI has corner-stone roles in diagnosing, characterizing and following-up of multi-sclerosis. Finally, we concluded that DIR can be used as a addition to or even as an alternative for typical T2 and FLAIR. Therefore, we strongly recommend the addition of DIR sequences in the everyday MR protocol of MS cases.

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Detection of Cortical Inflammatory Lesions by Double Inversion Recovery Magnetic Resonance Imaging in Patients With Multiple Sclerosis

Archives of Neurology ◽

10.1001/archneur.64.10.1416 ◽

2007 ◽

Vol 64 (10) ◽

pp. 1416 ◽

Cited By ~ 206

Author(s):

Massimiliano Calabrese ◽

Nicola De Stefano ◽

Matteo Atzori ◽

Valentina Bernardi ◽

Irene Mattisi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Magnetic Resonance ◽

Inversion Recovery ◽

Double Inversion Recovery ◽

Resonance Imaging ◽

Inflammatory Lesions

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Imaging central veins in brain lesions with 3-T T2*-weighted magnetic resonance imaging differentiates multiple sclerosis from microangiopathic brain lesions

Multiple Sclerosis Journal ◽

10.1177/1352458515616700 ◽

2016 ◽

Vol 22 (10) ◽

pp. 1289-1296 ◽

Cited By ~ 55

Author(s):

Niraj Mistry ◽

Rasha Abdel-Fahim ◽

Amal Samaraweera ◽

Olivier Mougin ◽

Emma Tallantyre ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

White Matter ◽

Magnetic Resonance ◽

Validation Cohort ◽

Brain Mri ◽

White Matter Lesions ◽

Brain Lesions ◽

Central Vein ◽

Resonance Imaging

Background: White matter lesions are frequently detected using brain magnetic resonance imaging (MRI) performed for various indications. Most are microangiopathic, but demyelination, including multiple sclerosis (MS), is an important cause; conventional MRI cannot always distinguish between these pathologies. The proportion of lesions with a central vein on 7-T T2*-weighted MRI prospectively distinguishes demyelination from microangiopathic lesions. Objective: To test whether 3-T T2*-weighted MRI can differentiate MS from microangiopathic brain lesions. Methods: A total of 40 patients were studied. Initially, a test cohort of 10 patients with MS and 10 patients with microangiopathic white matter lesions underwent 3-T T2*-weighted brain MRI. Anonymised scans were analysed blind to clinical data, and simple diagnostic rules were devised. These rules were applied to a validation cohort of 20 patients (13 with MS and 7 with microangiopathic lesions) by a blinded observer. Results: Within the test cohort, all patients with MS had central veins visible in >45% of brain lesions, while the rest had central veins visible in <45% of lesions. By applying diagnostic rules to the validation cohort, all remaining patients were correctly categorised. Conclusion: 3-T T2*-weighted brain MRI distinguishes perivenous MS lesions from microangiopathic lesions. Clinical application of this technique could supplement existing diagnostic algorithms.

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The Prognostic Value of White-Matter Selective Double Inversion Recovery MRI Sequence in Multiple Sclerosis: An Exploratory Study

Diagnostics ◽

10.3390/diagnostics11040686 ◽

2021 ◽

Vol 11 (4) ◽

pp. 686

Author(s):

Francesco Crescenzo ◽

Damiano Marastoni ◽

Anna Isabella Pisani ◽

Agnese Tamanti ◽

Caterina Dapor ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Magnetization Transfer ◽

Inversion Recovery ◽

Double Inversion Recovery ◽

Magnetization Transfer Ratio ◽

Tissue Properties ◽

Relapsing Remitting ◽

3.0 T

Using a white-matter selective double inversion recovery sequence (WM-DIR) that suppresses both grey matter (GM) and cerebrospinal fluid (CSF) signals, some white matter (WM) lesions appear surrounded by a dark rim. These dark rim lesions (DRLs) seem to be specific for multiple sclerosis (MS). They could be of great usefulness in clinical practice, proving to increase the MRI diagnostic criteria specificity. The aims of this study are the identification of DRLs on 1.5 T MRI, the exploration of the relationship between DRLs and disease course, the characterization of DRLs with respect to perilesional normal-appearing WM using magnetization transfer imaging, and the investigation of possible differences in the underlying tissue properties by assessing WM-DIR images obtained at 3.0 T MRI. DRLs are frequent in primary progressive MS (PPMS) patients. Amongst relapsing-remitting MS (RRMS) patients, DRLs are associated with a high risk of the disease worsening and secondary progressive MS (SPMS) conversion after 15 years. The mean magnetization transfer ratio (MTR) of DRLs is significantly different from the lesion without the dark rim, suggesting that DRLs correspond to more destructive lesions.

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Multiple sclerosis: High prevalence of the ‘central vein’ sign in white matter lesions on susceptibility-weighted images

The Neuroradiology Journal ◽

10.1177/1971400918763577 ◽

2018 ◽

Vol 31 (4) ◽

pp. 356-361 ◽

Cited By ~ 13

Author(s):

Gianvincenzo Sparacia ◽

Francesco Agnello ◽

Angelo Gambino ◽

Martina Sciortino ◽

Massimo Midiri

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Magnetic Resonance ◽

Small Vessel Disease ◽

White Matter Lesions ◽

Magnetic Resonance Images ◽

Inversion Recovery ◽

Central Vein ◽

Fluid Attenuated Inversion Recovery ◽

The Difference

Purpose The aim of this study was to determine the occurrence and distribution of the ‘central vein’ sign in white matter lesions on susceptibility-weighted magnetic resonance images in patients with multiple sclerosis (MS) and cerebral small vessel disease (CSVD). Materials and methods T2-weighted and fluid-attenuated inversion recovery magnetic resonance images of 19 MS patients and 19 patients affected by CSVD were analysed for the presence and localisation of focal hyperintense white matter lesions. Lesions were subdivided into periventricular or non-periventricular (juxtacortical, subcortical, deep white matter and cerebellar) distributed. The number and localisation of lesions presenting with the central vein sign were recorded and compared between MS and CSVD lesions. Results A total of 313 MS patients and 75 CSVD lesions were identified on T2-weighted and fluid-attenuated inversion recovery magnetic resonance images. The central vein sign was found in 128 MS lesions (40.9%), and the majority of them (71/128, 55.5%) had a periventricular distribution. The central vein sign was found in 22 out of 75 (29.3%) CSVD lesions, and periventricular distribution was seen in six out of 22 (27.2%) CSVD lesions. The difference in the proportion of white matter hyperintense lesions that presented with the central vein sign on susceptibility-weighted images in patients with MS and CSVD was statistically different, and a significantly higher number of MS patients presented with lesions with the central vein sign compared to CSVD patients. Conclusion The presence of the central vein sign on susceptibility-weighted images for MS lesions improves the understanding of the periventricular distribution of MS lesions and could contribute as adjunctive diagnostic criteria for MS disease.

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