Abstract
BackgroundMS is common demyelinating disease in which standard T2 and 2D-FLAIR MRI sequences play important role in its diagnosis. Recently, 3D-FLAIR sequence is used and has a role that is evaluated compared to standard sequences.ResultsThis study was performed on 20 selected MS patients. Brain MRI was performed using routinely used T2 and 2D FLAIR sequences, and 3D-FLAIR sequence was added. 3D-FLAIR images were reformatted, and all images were blindly analyzed. Lesions were counted in each sequence and classified according to their location into supratentorial lesions including periventricular, deep white matter, and juxta-cortical, and infratentorial lesions and relative comparison of lesion number on 3D-FLAIR versus 2D-FLAIR and T2 imaging, respectively, were expressed as percentage gain or a loss.3D-FLAIR sequence showed significantly more lesions compared to 2D FLAIR and T2 sequences in all locations with relative ratio of 29% and 41%, respectively, in periventricular region; 22% and 30%, respectively, in deep WM; 180% and 147%, respectively, in juxta-cortical region; and 80% and 13%, respectively, in infratentorial region.Conclusion3D-FLAIR sequence is of greater sensitivity than standard 2D-FLAIR and T2 sequences in MS brain lesions depiction, and it is recommended to be included in MR protocol of MS.
Highlights
Multiple sclerosis (MS) is common demyelinating disease in which standard T2 and 2D-FLAIR magnetic resonance imaging (MRI) sequences play important role in its diagnosis
T2 weight images plays important role in detection of MS lesions, lesion depiction is affected by bright cerebrospinal fluid signal in ventricular system and subarachnoid space that affect lesions in periventricular white matter and juxta-cortical region as both are bright, fluid-attenuated inversion recovery 2D-FLAIR helps to overcome this limitation by suppressing Cerebrospinal fluid (CSF) signal and yet creates good contrast between MS lesions and white matter [5]
In periventricular region (Fig. 3), the total number of lesions was depicted by 3D-FLAIR 107 lesions: 83 lesions by 2D-FLAIR sequence and 76 lesions by T2 pulse sequence in deep white matter region (Fig. 4); the total number of lesion depicted by 3D-FLAIR 112 lesions: 92 lesions by 2D-FLAIR sequence and 86 lesions by T2 pulse sequence; in juxta-cortical region (Figs. 5 and 6), the total number of lesions depicted by 3D-FLAI R 42 lesions: 15 lesions by 2D-FLAIR sequence and 17 lesions by T2 pulse sequence (Table 2, Fig. 7)
Summary
MS is common demyelinating disease in which standard T2 and 2D-FLAIR MRI sequences play important role in its diagnosis. Multiple sclerosis (MS) is a common auto-immune demyelinating inflammatory disease affecting the central nervous system including brain and spinal cord in which magnetic resonance imaging (MRI) plays an important role in diagnosis. MR imaging has a valuable role in diagnosis and follow-up of MS, as MS lesions formation leads to T2 weight images plays important role in detection of MS lesions, lesion depiction is affected by bright cerebrospinal fluid signal in ventricular system and subarachnoid space that affect lesions in periventricular white matter and juxta-cortical region as both are bright, fluid-attenuated inversion recovery 2D-FLAIR helps to overcome this limitation by suppressing CSF signal and yet creates good contrast between MS lesions and white matter [5].
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