Galler S, Stellmann J-P, Young K L, Kutzner D, Heesen C, Fiehler J, Siemonsen S
From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.)
Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
AJNR Am J Neuroradiol. 2016 May;37(5):963-9. doi: 10.3174/ajnr.A4638. Epub 2016 Jan 7.
Identification of lesions in specific locations gains importance in multiple sclerosis imaging diagnostic criteria. In clinical routine, axial scans are usually exclusively obtained to depict the cervical spinal cord or used to confirm suspected lesions on sagittal scans. We sought to evaluate the detection rate for MS lesions on axial T2WI scans with full spinal cord coverage in comparison with sagittal scans.
One hundred fifteen patients with definite or suspected MS underwent an MR imaging examination including 3-mm sagittal and 3.5-mm axial T2-weighted images with full spinal cord coverage. T2WI lesions were identified on axial and sagittal scans independently by 2 raters. Axial diameter, craniocaudal extension, lesion intensity, and location were analyzed.
Four hundred forty-nine of 509 (88.2%) lesions were detected on axial and 337/509 (66.2%) on sagittal scans. Only 277/449 (61.7%) axial lesions were also detected on sagittal images. The number of lesions visible on sagittal and axial images was dependent on the axial lesion diameter (P < .001).
Axial T2WI scans with full spinal cord coverage showed 22% more lesions in patients with MS in comparison with sagittal scans, especially for lesions with small axial diameters. We suggest including biplanar spinal MR imaging with full spinal cord coverage for lesion detection in MS in clinical routine and for clinical studies.
在多发性硬化症的影像学诊断标准中，特定部位病变的识别具有重要意义。在临床实践中，通常仅获取轴位扫描来显示颈髓，或用于在矢状位扫描上确认可疑病变。我们旨在评估与矢状位扫描相比，全脊髓覆盖的轴位T2WI扫描对MS病变的检出率。
115例确诊或疑似MS的患者接受了MR成像检查，包括3mm矢状位和3.5mm轴位T2加权图像，全脊髓覆盖。两名评估者分别独立在轴位和矢状位扫描上识别T2WI病变。分析病变的轴径、头尾延伸范围、病变强度和位置。
509个病变中，449个（88.2%）在轴位扫描上被检出，337个（66.2%）在矢状位扫描上被检出。矢状位图像上仅检出277个（61.7%）轴位病变。矢状位和轴位图像上可见的病变数量取决于轴位病变直径（P <.001）。
与矢状位扫描相比，全脊髓覆盖的轴位T2WI扫描在MS患者中显示的病变多22%，尤其是轴径较小的病变。我们建议在临床实践和临床研究中，将全脊髓覆盖的双平面脊柱MR成像纳入MS病变检测。
