Rofo 2005; 177 - A2
DOI: 10.1055/s-2005-931816

Dual Inversion Recovery Brain Imaging at 3 Tesla: Diagnostic value in the detection of MS lesions

MP Wattjes 1, G Lutterbey 1, L Klotz 1, J Gieseke 1, HH Schild 1
  • 1Department of Radiology, University of Bonn, Germany

Purpose: To prospectively determine and compare the sensitivity in the detection of multiple sclerosis (MS) lesions using Dual Inversion-Recovery (DIR), fluid-attenuated inversion recovery (FLAIR), and a T2-weighted turbo spin echo (T2 TSE) magnetic resonance imaging (MRI) at 3.0T in patients with suspected and definite MS.

Methods: 22 patients presenting with a clinically isolated syndrome (CIS) suggestion of MS and 2 patients with definite MS were included. Imaging was performed at a 3.0T whole body MRI system using DIR (TR 11000, TE 29, IR delay 3400, 325), FLAIR (TR 12000, TE 140, IR delay 2850), and T2 TSE (TR 3575, TE 100). For all sequences the same spatial resolution (measured voxel size of 0.9×0.9×5mm) was used. Image analysis was performed by two radiologists in consensus. High signal brain lesions were counted and classified according to five anatomic regions: infratentorial, periventricular, deep white matter, juxtacortical and mixed white matter-grey matter. Gain or loss of the lesions detected at the DIR was calculated in comparison with the corresponding FLAIR and T2 TSE pulse sequences.

Results: The DIR showed higher total number of lesions compared to the FLAIR (7% gain, p=0.07) and the T2 TSE (12% gain, p=0.01). Regarding the different anatomic regions the higher sensitivity was significant for the infratentorial region compared to the FLAIR (63% gain, p=0.04) and the T2 TSE (53% gain, p=0.04). Higher (but not statistically significant) lesion load was observed at DIR for the periventricular (10% gain) and mixed white matter-grey matter (23% gain) region compared to T2 TSE. Similar detection rates of all three sequences were observed regarding the juxtacortical and deep white matter region.

Conclusion: DIR brain imaging at 3.0T provides the highest sensitivity in the detection of MS lesions. This is especially significant for the infratentorial region leading to consequences for prognostic classifications.