@article {Riederer, author = {I. Riederer and N. Sollmann and M. M{\"u}hlau and C. Zimmer and J.S. Kirschke}, title = {Gadolinium-Enhanced 3D T1-Weighted Black-Blood MR Imaging for the Detection of Acute Optic Neuritis}, year = {2020}, doi = {10.3174/ajnr.A6807}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: A 3D T1-weighted black-blood sequence was recently shown to improve the detection of contrast-enhancing lesions in the brain in patients with MS compared with a 3D T1-weighted MPRAGE sequence. We compared a contrast-enhanced 3D T1-weighted black-blood sequence with a dedicated orbital contrast-enhanced T1-weighted Dixon sequence in patients with acute optic neuritis.MATERIALS AND METHODS: MR imaging data (3T) of 51 patients showing symptoms of acute optic neuritis were analyzed retrospectively, including whole-brain contrast-enhanced 3D T1-weighted black-blood and dedicated orbital coronal 2D or 3D contrast-enhanced T1-weighted Dixon sequences. Two neuroradiologists assessed the images for overall image quality, artifacts, diagnostic confidence, and visual contrast enhancement. Furthermore, the standardized contrast-to-noise ratio was calculated. The final diagnosis of acute optic neuritis was established on the basis of clinical presentation, visually evoked potentials, and optical coherence tomography.RESULTS: Thirty of 51 patients were diagnosed with acute optic neuritis. Of those, 21 showed contrast-enhancing lesions in the optic nerves, similarly detectable on contrast-enhanced T1-weighted Dixon and contrast-enhanced T1-weighted black-blood images. Thus, the accuracy for each sequence was identical, with a resulting sensitivity of 70\% and specificity of 90\% or 100\% (depending on the reader). Overall image quality, diagnostic confidence, visual contrast enhancement, and artifacts were rated similarly in contrast-enhanced 3D T1-weighted black-blood and dedicated orbital contrast-enhanced T1-weighted Dixon sequences. There was no significant difference (P = .27) in the mean standardized contrast-to-noise ratio between contrast-enhanced T1-weighted black-blood (1.76 {\textpm} 1.07) and contrast-enhanced T1-weighted Dixon (2.29 {\textpm} 2.49) sequences.CONCLUSIONS: Contrast-enhanced 3D T1-weighted black-blood imaging is comparable in accuracy and qualitative/quantitative features with dedicated orbital contrast-enhanced T1-weighted Dixon imaging for the detection of acute optic neuritis. Therefore, when used, it has the potential to considerably shorten total patient imaging time.BBblack-bloodDIRdouble inversion recoveryFSfat-suppressedOCToptical coherence tomographyONoptic neuritisVEPvisually evoked potentials}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/early/2020/10/29/ajnr.A6807}, eprint = {https://www.ajnr.org/content/early/2020/10/29/ajnr.A6807.full.pdf}, journal = {American Journal of Neuroradiology} }