Abstract
BackgroundMagnetic resonance imaging (MRI) is one of the diagnostic imaging modalities employing in lesion detection in neurological disorders such as multiple sclerosis (MS). Advances in MRI techniques such as double inversion recovery (DIR) made it more sensitive to distinguish lesions in the brain. To investigate the lesion load on different anatomical regions of the brain with MS using DIR, fluid attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI) sequences. A total of 97 MS patients were included in our retrospective study, confirmed by neurologist. The patients were randomly selected from the major hospital in Saudi Arabia. All images were obtained using 3T Scanner (Siemens Skyra). The images from the DIR, FLAIR, and T2WI sequence were compared on axial planes with identical anatomic position and the number of lesions was assigned to their anatomical region.ResultsComparing the lesion load measurement at various brain anatomical regions showed a significant difference among those three methods (p < 0.05).ConclusionDIR is a valuable MRI sequence for better delineation, greater contrast measurements and the increasing total number of MS lesions in MRI, compared with FLAIR, and T2WI and DIR revealed more intracortical lesions as well; therefore, in MS patients, it is recommended to add DIR sequence in daily routine imaging sequences.
Highlights
Magnetic resonance imaging (MRI) is one of the diagnostic imaging modalities employing in lesion detection in neurological disorders such as multiple sclerosis (MS)
The average total number of lesions among patients in all region based on double inversion recovery (DIR) was M = 37.67, fluid attenuated inversion recovery (FLAIR) was M = 29.57, and for T2weighted imaging (T2WI) was M = 27.47
The average number of lesions in infratentorial region based on DIR was M = 3.84, for FLAIR M = 2.31 and for T2WI was M = 2.87
Summary
Magnetic resonance imaging (MRI) is one of the diagnostic imaging modalities employing in lesion detection in neurological disorders such as multiple sclerosis (MS). Advances in MRI techniques such as double inversion recovery (DIR) made it more sensitive to distinguish lesions in the brain. To investigate the lesion load on different anatomical regions of the brain with MS using DIR, fluid attenuated inversion recovery (FLAIR) and T2weighted imaging (T2WI) sequences. Several studies revealed that most MS lesion load histologically are on the cerebral cortex the gray matter and white mater interface [5], Almutairi et al Egyptian Journal of Radiology and Nuclear Medicine (2020) 51:209 number of study have recently reported using of the double inversion recovery (DIR) technique provides higher quality images with adequate sensitivity in discriminating white matter from the gray matter lesions [11, 12]. Previous studies suggested that a major advantage of DIR is the positive association between clinical outcomes and cerebral cortex lesions [13, 14]. The potential of the DIR sequence over the conventional 2D FLAIR and T2W imaging sequences in detection of small size lesion in MS patients with an improved image contrast and its specificity in lesion detection encouraged us to assess the lesion load on MS patient among Saudi Arabian population using FLAIR, DIR, and T2 sequences
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