American Journal of Neuroradiology, Vol 17, Issue 8 1555-1565, Copyright © 1996 by American Society of Neuroradiology
ARTICLES |
Spinal cord lesions in patients with multiple sclerosis: comparison of MR pulse sequences
K Hittmair, R Mallek, D Prayer, EG Schindler and H Kollegger
Department of Neuroradiology, University of Vienna (Austria).
PURPOSE: To compare T2-weighted conventional spin-echo (CSE), fast spin- echo (FSE), shorttau inversion recovery (STIR) FSE, and fluid- attenuated inversion recovery (FLAIR) FSE sequences in the assessment of cervical multiple sclerosis plaques. METHODS: Twenty patients with clinically confirmed multiple sclerosis and signs of cervical cord involvement were examined on a 1.5-T MR system. Sagittal images of T2- weighted and proton density-weighted CSE sequences, T2-weighted FSE sequences with two different sets of sequence parameters, STIR-FSE sequences, and FLAIR-FSE sequences were compared by two independent observers. In addition, contrast-to-noise measurements were obtained. RESULTS: Spinal multiple sclerosis plaques were seen best on STIR-FSE images, which yielded the highest lesion contrast. Among the T2- weighted sequences, the FSE technique provided better image quality than did the CSE technique, but lesion visibility was improved only with a repetition time/echo time of 2500/90; parameters of 3000/150 provided poor lesion contrast but the best myelographic effect and overall image quality. CSE images were degraded by prominent image noise; FLAIR-FSE images showed poor lesion contrast and strong cerebrospinal fluid pulsation artifacts. CONCLUSIONS: The STIR-FSE sequence is the best choice for assessment of spinal multiple sclerosis plaques. For T2-weighted FSE sequences, shorter echo times are advantageous for spinal cord imaging, long echo times are superior for extramedullary and extradural disease. FLAIR-FSE sequences do not contribute much to spinal imaging for multiple sclerosis detection.
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