Kevin Y Wang1, Tomas A Uribe2, Christie M Lincoln2. 1. Department of Radiology, Baylor College of Medicine, Houston, TX, United States. Electronic address: yuqiw@bcm.edu. 2. Department of Radiology, Baylor College of Medicine, Houston, TX, United States.
Abstract
PURPOSE: Infratentorial lesions in patients with multiple sclerosis are associated with long-term disability. Two-dimensional fluid-attenuated inversion recovery demonstrates poor infratentorial lesion detection when compared to T2-weighted spin echo. Evidence of improved detection with 3D fluid-attenuated inversion recovery has been conflicting. This study compares the infratentorial lesion detection performance, observer performance, and signal and contrast properties between T2-weighted spin echo, 2D, and 3D fluid-attenuated inversion recovery. METHODS: Two board-certified radiologists independently reviewed and counted infratentorial lesions from 85 brain MRIs in patients with clinically definite multiple sclerosis and concurrent 3D, 2D fluid-attenuated inversion recovery, and T2-weighted spin echo sequences. Contrast-to-noise and signal-to-noise ratios were measured for 25 MRIs. Wilcoxon signed-rank test was used for pairwise comparisons of the combined average infratentorial lesion count, contrast-to-noise, and signal-to-noise ratios, and was adjusted for three pairwise comparisons using Bonferroni correction. A corrected p value < 0.05 was considered statistically significant. RESULTS: The number of lesions on 3D fluid-attenuated inversion recovery was significantly higher than those on 2D (p < 0.001) and T2-weighted spin echo (p < 0.001). Results of contrast-to-noise and signal-to-noise ratios were overall mixed and predominantly not concordant with lesion count findings, with T2-weighted spin echo demonstrating the highest signal-to-noise ratios and contrast-to-noise ratio of lesion compared with white matter but the lowest contrast-to-noise ratio of lesion compared with gray matter. CONCLUSION: The 3D fluid-attenuated inversion recovery sequence addresses the disadvantage of poor infratentorial lesion detection on 2D, while still maintaining the advantage over T2-weighted spin echo in the detection of lesions adjacent to the cerebrospinal fluid.
PURPOSE: Infratentorial lesions in patients with multiple sclerosis are associated with long-term disability. Two-dimensional fluid-attenuated inversion recovery demonstrates poor infratentorial lesion detection when compared to T2-weighted spin echo. Evidence of improved detection with 3D fluid-attenuated inversion recovery has been conflicting. This study compares the infratentorial lesion detection performance, observer performance, and signal and contrast properties between T2-weighted spin echo, 2D, and 3D fluid-attenuated inversion recovery. METHODS: Two board-certified radiologists independently reviewed and counted infratentorial lesions from 85 brain MRIs in patients with clinically definite multiple sclerosis and concurrent 3D, 2D fluid-attenuated inversion recovery, and T2-weighted spin echo sequences. Contrast-to-noise and signal-to-noise ratios were measured for 25 MRIs. Wilcoxon signed-rank test was used for pairwise comparisons of the combined average infratentorial lesion count, contrast-to-noise, and signal-to-noise ratios, and was adjusted for three pairwise comparisons using Bonferroni correction. A corrected p value < 0.05 was considered statistically significant. RESULTS: The number of lesions on 3D fluid-attenuated inversion recovery was significantly higher than those on 2D (p < 0.001) and T2-weighted spin echo (p < 0.001). Results of contrast-to-noise and signal-to-noise ratios were overall mixed and predominantly not concordant with lesion count findings, with T2-weighted spin echo demonstrating the highest signal-to-noise ratios and contrast-to-noise ratio of lesion compared with white matter but the lowest contrast-to-noise ratio of lesion compared with gray matter. CONCLUSION: The 3D fluid-attenuated inversion recovery sequence addresses the disadvantage of poor infratentorial lesion detection on 2D, while still maintaining the advantage over T2-weighted spin echo in the detection of lesions adjacent to the cerebrospinal fluid.
Authors: R E Gabr; J A Lincoln; A Kamali; O Arevalo; X Zhang; X Sun; K M Hasan; P A Narayana Journal: AJNR Am J Neuroradiol Date: 2020-10-08 Impact factor: 3.825
Authors: Massimo Filippi; Paolo Preziosa; Brenda L Banwell; Frederik Barkhof; Olga Ciccarelli; Nicola De Stefano; Jeroen J G Geurts; Friedemann Paul; Daniel S Reich; Ahmed T Toosy; Anthony Traboulsee; Mike P Wattjes; Tarek A Yousry; Achim Gass; Catherine Lubetzki; Brian G Weinshenker; Maria A Rocca Journal: Brain Date: 2019-07-01 Impact factor: 13.501
Authors: C Ngamsombat; A L M Gonçalves Filho; M G F Longo; S F Cauley; K Setsompop; J E Kirsch; Q Tian; Q Fan; D Polak; W Liu; W-C Lo; R Gilberto González; P W Schaefer; O Rapalino; J Conklin; S Y Huang Journal: AJNR Am J Neuroradiol Date: 2021-07-08 Impact factor: 4.966