American Journal of Neuroradiology 20:1710-1716 (10 1999)
© 1999 American Society of Neuroradiology
ARTICLE
Comparison of Three MR Sequences for the Detection of Cervical Cord Lesions in Patients with Multiple Sclerosis
a From the Neuroimaging Research Unit (M.A.R., G.M., C.P., G.I., M.F.) and the Clinical Trials Unit (B.C., L.M., G.C.), Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy; and the Department of Medical Physics, University of Leicester, UK (M.A.H.).
BACKGROUND AND PURPOSE: Improving the sensitivity of MR imaging for the detection of multiple sclerosis (MS) lesions in the cord might be useful in the diagnostic workup and could lead to a better understanding of the evolution of the disease. The purpose of this study was to compare fast spin-echo (FSE) with magnetization transfer–prepared gradient-echo (MT-GE) and fast short-inversion-time inversion recovery (fast-STIR) MR sequences to determine which is best for imaging cervical cord lesions in MS patients.
METHODS: FSE, MT-GE, and fast-STIR MR images were obtained in 56 MS patients and 10 healthy control subjects with a 1.5-T MR system and a phased-array coil. Cord lesions seen on images obtained with each sequence were counted by two observers in two stages (stage 1: random review of the complete sets of images from each technique; stage 2: side-by-side review with a retrospective count of lesions).
RESULTS: At the end of stage 1, a mean of 1.16 cord lesions per patient were seen on FSE images, 1.57 on MT-GE images (35% more than on FSE), and 1.92 on fast-STIR images (66% more than on FSE). Two or more cervical cord lesions were found on 16 FSE images (29%), 23 on MT-GE images (46%), and 30 on fast-STIR images (54%). Differences were reduced after stage 2: MT-GE detected 22% more lesions and fast-STIR 36% more lesions than FSE. Considering the three sequences together, 113 cervical cord lesions were seen in 50 patients (89%).
CONCLUSION: Both MT-GE and fast-STIR sequences depict more cervical cord MS lesions than the FSE sequence, with fast-STIR having the best sensitivity. Fast-STIR MR images may be useful for the diagnostic workup of patients with suspected MS and for improving our understanding of the evolution of MS.
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