Department of Neuroradiology, Hôpital Roger Salengro, Rue Emile Laine, 59037, Lille, France,
Eur Radiol. 2014 Dec;24(12):3069-75. doi: 10.1007/s00330-014-3342-3. Epub 2014 Aug 23.
We compared the three-dimensional (3D) double inversion recovery (DIR) magnetic resonance imaging (MRI) sequence with the coronal two-dimensional (2D) short tau inversion recovery (STIR) fluid-attenuated inversion recovery (FLAIR) for the detection of optic nerve signal abnormality in patients with optic neuritis (ON).
The study group consisted of 31 patients with ON (44 pathological nerves) confirmed by visual-evoked potentials used as the reference. MRI examinations included 2D coronal STIR FLAIR and 3D DIR with 3-mm coronal reformats to match with STIR FLAIR. Image artefacts were graded for each portion of the optic nerves. Each set of MR images (2D STIR FLAIR, DIR reformats and multiplanar 3D DIR) was examined independently and separately for the detection of signal abnormality.
Cisternal portion of optic nerves was better delineated with DIR (p < 0.001), while artefacts impaired analysis in four patients with STIR FLAIR. Inter-observer agreement was significantly improved (p < 0.001) on 3D DIR (κ = 0.96) compared with STIR FLAIR images (κ = 0.60). Multiplanar DIR images reached the best performance for the diagnosis of ON (95% sensitive and 94% specific).
Our study showed a high sensitivity and specificity of 3D DIR compared with STIR FLAIR for the detection of ON. These findings suggest that the 3D DIR sequence may be more useful in patients suspected of ON.
3D DIR is increasingly used in neuroradiology. Compared with STIR FLAIR, 3D DIR improves detection of optic neuritis. Multiplanar analysis had the best diagnostic performance for optic nerve signal abnormalities. Sensitivity was 95% and specificity 94%. Findings support the use of 3D DIR instead of 2D sequences.
我们比较了三维（3D）双反转恢复（DIR）磁共振成像（MRI）序列与冠状二维（2D）短 tau 反转恢复（STIR）液体衰减反转恢复（FLAIR），以检测视神经炎（ON）患者视神经信号异常。
研究组包括 31 例经视觉诱发电位证实的 ON 患者（44 根病变神经）作为参考。MRI 检查包括冠状 2D STIR FLAIR 和 3D DIR，冠状 3mm 重建与 STIR FLAIR 匹配。对每根视神经的各个部分进行图像伪影分级。每一组 MRI 图像（2D STIR FLAIR、DIR 重建和多平面 3D DIR）都进行了独立和分别的检查，以检测信号异常。
视神经管内段用 DIR 显示更好（p<0.001），而 STIR FLAIR 有 4 例出现伪影影响分析。与 STIR FLAIR 图像（κ=0.60）相比，3D DIR 的观察者间一致性显著提高（p<0.001）（κ=0.96）。多平面 DIR 图像对 ON 的诊断效果最佳（95%敏感，94%特异）。
与 STIR FLAIR 相比，我们的研究显示 3D DIR 对 ON 的检测具有较高的敏感性和特异性。这些发现表明，3D DIR 序列在疑似 ON 的患者中可能更有用。
3D DIR 在神经影像学中越来越多地使用。与 STIR FLAIR 相比，3D DIR 提高了视神经炎的检出率。多平面分析对视神经信号异常的诊断性能最佳。敏感性为 95%，特异性为 94%。研究结果支持使用 3D DIR 而不是 2D 序列。
