Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
Department of Neurosurgery, Emory University, Atlanta, Georgia.
J Neuroimaging. 2021 Mar;31(2):408-414. doi: 10.1111/jon.12822. Epub 2020 Dec 22.
The comparative detection rates of deep gray matter (GM) multiple sclerosis (MS) lesions using double inversion recovery (DIR) and fluid-attenuated inversion-recovery (FLAIR) on 3T MR imaging remain unknown. We aimed to assess the detectability of cortical and deep GM MS lesions using DIR and FLAIR on 3T clinical exams and evaluate the relationship between deep GM lesions and brain atrophy.
One hundred fifty consecutive MS patients underwent routine brain MRI that included 3D DIR and 2D T2 FLAIR on the same 3T scanner. Three neuroradiologists independently reviewed all exams for cortical and deep GM lesions. Statistical parametric mapping (SPM) and FMRIB software library (FSL)-FIRST pipelines were used to determine normalized whole brain and deep GM volumes.
A total of 65 cortical and 98 deep lesions were detected on DIR versus 24 and 20, respectively, on FLAIR. Among all 150 patients, the number and percentage of patients with GM lesions on DIR and FLAIR were as follows: cortical 43 (28.7%) versus 24 (16.0%) (P < .001), thalamus 47 (31.3%) versus 20 (13.3%) (P < .001), putamen 10 (6.7%) versus 3 (2.0%) (P = .02), globus pallidus 9 (6.0%) versus 3 (1.3%) (P = .02), and caudate 5 (3.3%) versus 1 (0.7%) (P = .125). Presence of deep GM lesions weakly correlated with deep GM volume fractions.
Deep GM MS lesions can be detected using routine clinical brain MRI including DIR and FLAIR at 3T. Future studies to optimize these sequences may improve the detection rates of cortical and deep GM lesions. The presence of GM lesions showed weak correlation with GM atrophy.
在 3T 磁共振成像中，双反转恢复（DIR）和液体衰减反转恢复（FLAIR）对深部灰质（GM）多发性硬化（MS）病变的比较检出率尚不清楚。我们旨在评估 3T 临床检查中 DIR 和 FLAIR 对皮质和深部 GM MS 病变的检测能力，并评估深部 GM 病变与脑萎缩之间的关系。
150 例连续 MS 患者接受了常规脑部 MRI 检查，包括在同一台 3T 扫描仪上进行 3D DIR 和 2D T2 FLAIR。三位神经放射科医生独立评估了所有检查的皮质和深部 GM 病变。统计参数映射（SPM）和 FMRIB 软件库（FSL）-FIRST 管道用于确定正常化全脑和深部 GM 体积。
在 DIR 上共检测到 65 个皮质病变和 98 个深部 GM 病变，而在 FLAIR 上分别检测到 24 个和 20 个。在所有 150 例患者中，DIR 和 FLAIR 上 GM 病变的例数和百分比如下：皮质病变 43（28.7%）比 24（16.0%）（P<.001），丘脑病变 47（31.3%）比 20（13.3%）（P<.001），壳核病变 10（6.7%）比 3（2.0%）（P=.02），苍白球病变 9（6.0%）比 3（1.3%）（P=.02），尾状核病变 5（3.3%）比 1（0.7%）（P=.125）。深部 GM 病变的存在与深部 GM 体积分数呈弱相关性。
在 3T 上，常规临床脑部 MRI 包括 DIR 和 FLAIR 可检测深部 GM MS 病变。未来优化这些序列的研究可能会提高皮质和深部 GM 病变的检出率。GM 病变的存在与 GM 萎缩呈弱相关性。
