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Altered signal intensity of active enhancing inflammatory lesions using post-contrast double inversion recovery MR sequence.

Abstract：

OBJECTIVES:We aimed at establishing the impact upon gadolinium administration on the conspicuity of active enhancing multiple sclerosis (MS) lesions using double inversion recovery (DIR) at 3T. METHODS:15 consecutive patients with MS (n=8) or a clinically isolated syndrome (n=7) underwent pre and post-contrast DIR in addition to T2-weighted, FLAIR, pre and post-contrast T1-weighted sequences. First, two neuroradiologists located and marked all the enhancing MS lesions visible in consensus. Second, two other neuroradiologists, blinded to other sequences than DIR, independently assessed the SI changes from pre to post-contrast DIR images for each enhancing lesion, according to a 4-point-scale: increased SI (grade 1), absence of change (grade 2), lesion being partially (grade 3) or completely masked on post-contrast DIR images (grade 4). RESULTS:246 MS lesions were detected including 26 enhancing on post-contrast T1-weighted images in 9 patients. The two blinded readers concluded to a decreased signal-intensity on post-contrast DIR images for all the 26 enhancing MS lesions (14 of grade 3 and 12 of grade 4). Inter-observer agreement was excellent, Kappa=0.85 (0.75 - 0.94). Using DIR post-contrast leads to altered signal-intensity of enhancing active MS lesions, ranging from partial to complete signal-loss. CONCLUSION:Our study strongly suggests the use of DIR before gadolinium administration. KEY POINTS:• DIR has gained widespread use in MS. • MRI protocols for MS patients usually contain several post-contrast sequences. • Signal-intensity of enhancing MS lesions is altered using DIR post-contrast. • Our study strongly suggests the use of DIR before gadolinium administration.

journal_name

Eur Radiol

journal_title

European radiology

authors

Hodel J,Badr S,Outteryck O,Lebert P,Chechin D,Benadjaoud MA,Pruvo JP,Vermersch P,Leclerc X

doi

10.1007/s00330-016-4416-1

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

637-641

issue

2

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-016-4416-1

journal_volume

27

pub_type

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