Brain MR imaging protocol
| Sequence | Diagnostic Scan for Clinically Isolated Syndrome | MS Baseline or Follow-up Scan | Comment | |
|---|---|---|---|---|
| 1 | 3 plane (or other) scout | Recommended | Recommended | Set up axial sections through subcallosal line* |
| 2 | Sagittal Fast FLAIR | Recommended | Optional | Sagittal FLAIR sensitive to early MS pathology, such as in corpus callosum |
| 3 | Axial FSE PD/T2 | Recommended | Recommended | TE1 minimum (eg, ≤30 ms) |
| TE2 (usually ≥80 ms) | ||||
| PD series sensitive to infratentorial lesions that may be missed by FLAIR series | ||||
| 4 | Axial Fast FLAIR | Recommended | Recommended | Sensitive to white matter lesions and especially juxtacortical–cortical lesions |
| 5 | Axial pregadolinium T1 | Optional | Optional | Considered routine for most neuroimaging studies |
| 6 | 3D T1 | Optional | Optional | Some centers use this for atrophy measures. |
| 7 | Axial gadolinium-enhanced T1 | Recommended | Optional | Standard dose of 0.1 mmol/kg injected over 30 s; scan starting minimum 5 min after start of injection |
Note.—FSE indicates fast spin-echo (or turbo spin-echo); PD, proton density-weighted (long TR, short TE sequence); T2, T2-weighted (long TR, long TE sequence); T1, T1-weighted (short TR, short TE sequence). Section thickness for sequences 3–6 is ≤3 mm with no intersection gaps when feasible. Partition thickness for 3D sequence 6 is ≤1.5 mm. In-plane resolution is approximately ≤1 × 1 mm.
* The subcallosal line joins the undersurface of the front (rostrum) and back (splenium) of the corpus callosum.