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Research ArticleBRAIN

Does High-field MR Imaging Have an Influence on the Classification of Patients with Clinically Isolated Syndromes According to Current Diagnostic MR Imaging Criteria for Multiple Sclerosis?

M.P. Wattjes, M. Harzheim, C.K. Kuhl, J. Gieseke, S. Schmidt, L. Klotz, T. Klockgether, H.H. Schild and G.G. Lutterbey
American Journal of Neuroradiology September 2006, 27 (8) 1794-1798;
M.P. Wattjes
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M. Harzheim
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C.K. Kuhl
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J. Gieseke
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S. Schmidt
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L. Klotz
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T. Klockgether
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H.H. Schild
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G.G. Lutterbey
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    Fig 1.

    Top row: T2-weighted images of a 19-year-old patient presenting with unilateral optic neuritis. One infratentorial lesion in the brain stem (arrow) could be identified on the 3T image but not on the corresponding 1.5T image. Bottom row: FLAIR images of a 30-year-old patient presenting with unilateral optic neuritis. The 3T image shows infratentorial lesions in the brain stem and the cerebellum (arrows) which were not prospectively identified on the corresponding 1.5T image.

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    Fig 2.

    Identical axial sections of FLAIR images within the supratentorial brain obtained at 3T (left) and 1.5T (right) MR imaging. One more juxtacortical lesion (arrow) could be identified on the 3T FLAIR images in comparison with the corresponding 1.5T examination.

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    Table 1:

    MR imaging sequence parameters

    Pulse Sequence
    SystemFLAIRT2 TSET1 SE
    1.5T3T1.5T3T1.5T3T
    Field of view (mm)230230230230230230
    Matrix256256256256256256
    Section thickness (mm)555555
    Measured voxel size (mm)0.90/0.90/50.90/0.90/50.90/0.90/50.90/0.90/50.90/0.90/50.90/0.90/5
    Turbo factor29382316
    Number of signals averaged212121
    Repetition time (ms)600012 00035004100500500
    Echo time (ms)1101401001001212
    Inversion time (ms)20002850
    Acquisition time (min:s)3:004:002:272:193:343:27
    • Note:— FLAIR indicates fluid-attenuated inversion recovery; TSE, turbo spin-echo; SE, spin-echo.

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    Table 2:

    Patients with discordant results between 1.5T and 3T according to Barkhof MR imaging criteria

    Patient No.Clinical PresentationNumber of Fulfilled MR Imaging CriteriaAdditional MR Imaging Criterion
    1.5T3T
    1Optic neuritis01≥1 juxtacortical lesion
    2Optic neuritis01≥1 infratentorial lesion
    3Brain stem syndrome12≥9 T2 hyperintense lesions
    4Brain stem syndrome12≥9 T2 hyperintense lesions
    5Brain stem syndrome12≥1 juxtacortical lesion
    6Optic neuritis12≥9 T2 hyperintense lesions
    7Optic neuritis12≥1 infratentorial lesion
    8*Optic neuritis23≥1 infratentorial lesion
    9*Optic neuritis23≥9 T2 hyperintense lesions
    10Optic neuritis34≥3 periventricular lesions
    11Spinal cord syndrome34≥1 infratentorial lesion
    • * Patient fulfilled 3 criteria instead of 2 at 3T, and they were therefore diagnosed of having lesion dissemination in space according to McDonald diagnostic criteria.

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American Journal of Neuroradiology: 27 (8)
American Journal of Neuroradiology
Vol. 27, Issue 8
September 2006
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Does High-field MR Imaging Have an Influence on the Classification of Patients with Clinically Isolated Syndromes According to Current Diagnostic MR Imaging Criteria for Multiple Sclerosis?
M.P. Wattjes, M. Harzheim, C.K. Kuhl, J. Gieseke, S. Schmidt, L. Klotz, T. Klockgether, H.H. Schild, G.G. Lutterbey
American Journal of Neuroradiology Sep 2006, 27 (8) 1794-1798;

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Does High-field MR Imaging Have an Influence on the Classification of Patients with Clinically Isolated Syndromes According to Current Diagnostic MR Imaging Criteria for Multiple Sclerosis?
M.P. Wattjes, M. Harzheim, C.K. Kuhl, J. Gieseke, S. Schmidt, L. Klotz, T. Klockgether, H.H. Schild, G.G. Lutterbey
American Journal of Neuroradiology Sep 2006, 27 (8) 1794-1798;
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  • Improving Detection of Multiple Sclerosis Lesions in the Posterior Fossa Using an Optimized 3D-FLAIR Sequence at 3T
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  • Normal Findings on Brain Fluid-Attenuated Inversion Recovery MR Images at 3T
  • Axonal Damage But No Increased Glial Cell Activity in the Normal-Appearing White Matter of Patients with Clinically Isolated Syndromes Suggestive of Multiple Sclerosis Using High-Field Magnetic Resonance Spectroscopy
  • Clinical evaluation of a speed optimized T2 weighted fast spin echo sequence at 3.0 T using variable flip angle refocusing, half-Fourier acquisition and parallel imaging
  • Can imaging techniques measure neuroprotection and remyelination in multiple sclerosis?
  • Double Inversion Recovery Brain Imaging at 3T: Diagnostic Value in the Detection of Multiple Sclerosis Lesions
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