Diagnostic accuracy of double inversion recovery (DIR) in detection of cortical gray matter lesions in patients with MS

Mahmoud M Higazi,Alaa Wagih Fathy,Manal F Abu Samra,Hosny Sayed Abd El Ghany,Muhammad Mamdouh Ismail

doi:10.1186/s43055-021-00668-x

Mahmoud M Higazi, Alaa Wagih Fathy + Show 3 more

Open Access

https://doi.org/10.1186/s43055-021-00668-x

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Abstract

BackgroundConventional imaging techniques have a low sensitivity for detection of cortical and deep grey matter lesions in MS which hinder accurate assessment of the total lesion burden. Aim of this work was to assess the diagnostic accuracy of double inversion recovery (DIR) sequence in the detection of cortical grey matter lesions in MS patients.ResultsForty MS patients were prospectively included in this study. Imaging was performed using Philips Ingenia 1.5 T device. The sensitivity, specificity, PPV, NPV and accuracy of DIR sequence in detection of cortical grey matter lesions were 60%, 100%, 100%, 55.6% and 73.3%, respectively. The sensitivity, specificity, positive and negative predictive values as well as accuracy of Flair sequence were 50%, 100%, 100%, 50% and 66.7%, respectively. The sensitivity, specificity, positive and negative predictive values as well as accuracy of T2 sequence in the detection of cortical grey matter lesions were 22.5%, 100%, 100%, 39.2% and 48.3%, respectively.ConclusionsDetection rate of cortical gray matter lesions was significantly higher on DIR sequence than on T2 and Flair sequences.

Highlights

Conventional imaging techniques have a low sensitivity for detection of cortical and deep grey matter lesions in multiple sclerosis (MS) which hinder accurate assessment of the total lesion burden
All patients were diagnosed in neuropsychiatry department, and they were referred to our department of radio-diagnosis for Magnetic resonance imaging (MRI) examination
Demographics and clinical data Demographic and clinical variables in 40 multiple sclerosis (MS) patients and 20 controls who were included in the study are shown in the following Tables and Figs. 1, 2, 3, 4 and 5

Summary

Results

A statistically significant difference was found between different MRI sequences (DIR, T2 and Flair) as regarding number of cortical grey mater lesions among studied MS patients (P < 0.001). It was found that there was statistically significant strong positive correlation between number of cortical grey matter lesions in different MRI pulse sequences (T2, Flair and DIR) versus EDSS. The sensitivity, specificity, PPV, NPV and accuracy of DIR sequence in detection of cortical grey matter lesions were 60%, 100%, 100%, 55.6% and 73.3%, respectively. The sensitivity, specificity, positive and negative predictive values as well as accuracy of Flair sequence were 50%, 100%, 100%, 50% and 66.7%, respectively. The sensitivity, specificity, positive and negative predictive values as well as accuracy of T2 sequence in the detection of cortical grey matter lesions were 22.5%, 100%, 100%, 39.2% and 48.3%, respectively (Table 8)

Background

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Conclusion