Monash Imaging, Monash Health, Melbourne, Australia.
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
Neuroradiol J. 2021 Dec;34(6):600-606. doi: 10.1177/19714009211017787. Epub 2021 May 20.
The magnetic resonance imaging in multiple sclerosis consensus guidelines currently mandate three sagittal non-contrast enhanced sequences of T2-weighted fast spin echo, proton density-weighted fast spin echo and short tau inversion recovery; however, these particular three sequences have not previously been compared at 3T. This study compared T2-weighted fast spin echo, proton density-weighted fast spin echo, short tau inversion recovery as well as the double inversion recovery sequence for the sagittal detection of multiple sclerosis lesions in the cervical spinal cord at 3T.
Nineteen multiple sclerosis patients underwent magnetic resonance imaging with 3T sagittal T2-weighted fast spin echo, proton density-weighted fast spin echo, short tau inversion recovery and double inversion recovery between November 2012 and April 2013. Two neuroradiologists independently reviewed the images, and the number of lesions detected on each sequence was recorded. Lesion conspicuity was quantitatively assessed with the lesion-to-cord-contrast ratio and lesion contrast-to-noise ratio. The Wilcoxon signed rank test was performed for statistical analysis.
Proton density-weighted fast spin echo and short tau inversion recovery detected 32% more lesions compared to T2-weighted fast spin echo, and 37% more lesions compared to double inversion recovery. The lesion-to-cord-contrast ratio was highest in short tau inversion recovery, while the lesion contrast-to-noise ratio was highest for proton density-weighted fast spin echo.
This study provides the necessary evidentiary support at 3T for the magnetic resonance imaging in multiple sclerosis spinal magnetic resonance imaging protocol consensus guidelines. At 3T sagittal proton density-weighted fast spin echo and short tau inversion recovery sequences allowed improved detection of cervical spinal cord multiple sclerosis lesions, compared to T2-weighted fast spin echo and three-dimensional double inversion recovery magnetic resonance imaging. Utilising T2-weighted fast spin echo alone at 3T is insufficient for lesion detection.
目前，多发性硬化症磁共振成像共识指南要求进行 3 个矢状位非对比增强 T2 加权快速自旋回波、质子密度加权快速自旋回波和短τ反转恢复序列；然而，这些特定的 3 个序列以前并未在 3T 下进行比较。本研究比较了 T2 加权快速自旋回波、质子密度加权快速自旋回波、短τ反转恢复以及双反转恢复序列在 3T 下对颈脊髓多发性硬化病变的矢状面检测。
19 例多发性硬化症患者于 2012 年 11 月至 2013 年 4 月期间在 3T 下行矢状位 T2 加权快速自旋回波、质子密度加权快速自旋回波、短τ反转恢复和双反转恢复磁共振成像。两位神经放射科医生独立对图像进行了评估，并记录了每个序列上检测到的病变数量。使用病变与脊髓对比度比和病变对比度噪声比定量评估病变的显著程度。采用 Wilcoxon 符号秩检验进行统计学分析。
质子密度加权快速自旋回波和短τ反转恢复序列比 T2 加权快速自旋回波分别多检测到 32%和 37%的病变，比三维双反转恢复序列分别多检测到 32%和 37%的病变。短τ反转恢复序列的病变与脊髓对比度比最高，而质子密度加权快速自旋回波的病变对比度噪声比最高。
本研究在 3T 下为多发性硬化症脊髓磁共振成像协议共识指南提供了必要的证据支持。在 3T 下，与 T2 加权快速自旋回波和三维双反转恢复磁共振成像相比，矢状位质子密度加权快速自旋回波和短τ反转恢复序列可以更好地检测颈脊髓多发性硬化病变。在 3T 下仅使用 T2 加权快速自旋回波不足以进行病变检测。
