Standardized brain MRI protocol (diagnosis and routine follow-up of MS)
| Parameters | Description |
|---|---|
| Field strength | Scans should be of good quality, with adequate SNR and resolution (in-sections, pixel resolution of ≤1 × 1 mm) |
| Scan prescription | Use the subcallosal plane to prescribe or reformat axial oblique sections (Fig 1) |
| Coverage | Whole-brain coverage |
| Section thickness and gap | ≤3 mm, No gap (for 2D acquisition or 3D reconstruction) |
| Core sequences | Anatomic 3D inversion recovery–prepared T1 gradient echo (eg, 1.0- to 1.5-mm thickness) |
| Gadolinium single dose, 0.1 mmol/kg given for 30 secondsa | |
| 3D sagittal T2WI FLAIRb (eg, 1.0- to 1.5-mm thickness) | |
| 3D T2WI b (eg, 1.0- to 1.5-mm thickness) | |
| 2D axial DWI (≤5-mm sections, no gap) | |
| 3D FLASH (non-IR prep) postgadoliniumb (eg, 1.0- to 1.5-mm thickness) | |
| 3D series would be typically reconstructed to 3-mm thickness for display and subsequent comparison for lesion counts | |
| Optional sequences | Axial proton attenuation |
| Pre- or postgadolinium axial T1 spin-echo (for chronic black holes) | |
| SWI for identification of central vein within T2 lesions |
Note:—IR indicates inversion recovery.
↵a Minimum 5-minute delay before obtaining postgadolinium T1. The 3D sagittal FLAIR may be acquired immediately after contrast injection before the 3D FLASH series.
↵b If unable to perform a 3D acquisition, then perform 2D axial and sagittal FLAIR, axial fast spin-echo proton attenuation/T2, and axial post-gadolinium T1WI spin-echo at ≤3-mm section thickness.