Table 1:

Brain MR imaging protocol

SequenceDiagnostic Scan for Clinically Isolated SyndromeMS Baseline or Follow-up ScanComment
13 plane (or other) scoutRecommendedRecommendedSet up axial sections through subcallosal line*
2Sagittal Fast FLAIRRecommendedOptionalSagittal FLAIR sensitive to early MS pathology, such as in corpus callosum
3Axial FSE PD/T2RecommendedRecommendedTE1 minimum (eg, ≤30 ms)
TE2 (usually ≥80 ms)
PD series sensitive to infratentorial lesions that may be missed by FLAIR series
4Axial Fast FLAIRRecommendedRecommendedSensitive to white matter lesions and especially juxtacortical–cortical lesions
5Axial pregadolinium T1OptionalOptionalConsidered routine for most neuroimaging studies
63D T1OptionalOptionalSome centers use this for atrophy measures.
7Axial gadolinium-enhanced T1RecommendedOptionalStandard 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.