Hodel J, Outteryck O, Ryo E, Bocher A-L, Lambert O, Chéchin D, Zéphir H, Lacour A, Pruvo J-P, Vermersch P, Leclerc X
From the Departments of Neuroradiology (J.H., E.R., A.-L.B., J.-P.P., X.L.).
AJNR Am J Neuroradiol. 2014 Mar;35(3):519-23. doi: 10.3174/ajnr.A3795. Epub 2013 Nov 7.
Therapeutic strategies for patients with MS partly rely on contrast-enhanced MR imaging. Our aim was to assess the diagnostic performance of 3D turbo spin-echo MR imaging with variable refocusing flip angles at 3T for the detection of enhanced inflammatory lesions in patients with multiple sclerosis.
Fifty-six patients with MS were prospectively investigated by using postcontrast T1-weighted axial 2D spin-echo and 3D TSE MR images. The order in which both sequences were performed was randomized. Axial reformats from 3D T1 TSE were generated to match the 2D spin-echo images. The reference standard was defined by using clinical data and all MR images available. Three separate sets of MR images (2D spin-echo images, axial reformats, and multiplanar images from 3D TSE sequences) were examined in a blinded fashion by 2 neuroradiologists separately for the detection of enhanced MS lesions. Image artifacts and contrast were evaluated.
No artifacts related to vascular pulsation were observed on 3D TSE images, whereas image artifacts were demonstrated on 2D spin-echo images in 41 patients. One hundred twelve enhanced MS lesions were identified in 19 patients. Sixty-four lesions were correctly diagnosed by using 2D spin-echo images; 90, by using 3D TSE axial reformatted views; and 106, by using multiplanar analysis of the 3D TSE sequence. Multiplanar analysis was 94.7% sensitive and 100% specific for the diagnosis of patients with at least 1 enhanced lesion. Contrast of enhanced MS lesions was significantly improved by using the 3D TSE sequence (P < .011).
The 3D TSE sequence with multiplanar analysis is a useful tool for the detection of enhanced MS lesions.
多发性硬化症（MS）患者的治疗策略部分依赖于对比增强磁共振成像。我们的目的是评估3T下具有可变重聚焦翻转角的三维快速自旋回波磁共振成像对检测多发性硬化症患者强化炎性病变的诊断性能。
对56例MS患者进行前瞻性研究，采用对比剂增强后的T1加权轴向二维自旋回波和三维快速自旋回波磁共振图像。两个序列的执行顺序是随机的。生成三维T1快速自旋回波的轴向重组图像以匹配二维自旋回波图像。参考标准通过临床数据和所有可用的磁共振图像来定义。由2名神经放射科医生分别以盲法检查三组独立的磁共振图像（二维自旋回波图像、轴向重组图像和三维快速自旋回波序列的多平面图像），以检测强化的MS病变。评估图像伪影和对比度。
在三维快速自旋回波图像上未观察到与血管搏动相关的伪影，而41例患者的二维自旋回波图像上出现了图像伪影。在19例患者中识别出112个强化的MS病变。使用二维自旋回波图像正确诊断了64个病变；使用三维快速自旋回波轴向重组视图正确诊断了90个病变；使用三维快速自旋回波序列的多平面分析正确诊断了106个病变。多平面分析对诊断至少有1个强化病变的患者的敏感性为94.7%，特异性为100%。使用三维快速自旋回波序列显著改善了强化MS病变的对比度（P < 0.011）。
具有多平面分析的三维快速自旋回波序列是检测强化MS病变的有用工具。
