Detection Of Spinal Cord Lesions Research Articles

Contribution of the MP2RAGE 7T Sequence in MS Lesions of the Cervical Spinal Cord.

The detection of spinal cord lesions in patients with MS is challenging. Recently, the 3D MP2RAGE sequence demonstrated its usefulness at 3T. Benefiting from the high spatial resolution provided by ultra-high-field MR imaging systems, we aimed to evaluate the contribution of the 3D MP2RAGE sequence acquired at 7T for the detection of MS lesions in the cervical spine. Seventeen patients with MS participated in this study. They were examined at both 3T and 7T. The MR imaging examination included a Magnetic Imaging in MS (MAGNIMS) protocol with an axial T2*-WI gradient recalled-echo sequence ("optimized MAGNIMS protocol") and a 0.9-mm isotropic 3D MP2RAGE sequence at 3T, as well as a 0.7-mm isotropic and 0.3-mm in-plane-resolution anisotropic 3D MP2RAGE sequences at 7T. Each data set was read by a consensus of radiologists, neurologists, and neuroscientists. The number of lesions and their topography, as well as the visibility of the lesions from one set to another, were carefully analyzed. A total of 55 lesions were detected. The absolute number of visible lesions differed among the 4 sequences (linear mixed effect ANOVA, P = .020). The highest detection was observed for the two 7T sequences with 51 lesions each (92.7% of the total). The optimized 3T MAGNIMS protocol and the 3T MP2RAGE isotropic sequence detected 41 (74.5%) and 35 lesions (63.6%), respectively. The 7T MP2RAGE sequences detected more lesions than the 3T sets. Isotropic and anisotropic acquisitions performed comparably. Ultra-high-resolution sequences obtained at 7T improve the identification and delineation of lesions of the cervical spinal cord in MS.

3D-Fast Gray Matter Acquisition with Phase Sensitive Inversion Recovery Magnetic Resonance Imaging at 3 Tesla: Application for detection of spinal cord lesions in patients with multiple sclerosis

To compare 3D-Fast Gray Matter Acquisition with Phase Sensitive Inversion Recovery (3D-FGAPSIR) with conventional 3D-Short-Tau Inversion Recovery (3D-STIR) and sagittal T1-and T2-weighted MRI dataset at 3 Tesla when detecting MS spinal cord lesions. This prospective single-center study was approved by an institutional review board and enrolled participants from December 2016 to August 2018. Two neuroradiologists blinded to all data, individually analyzed the 3D-FGAPSIR and the conventional datasets separately and in random order. Discrepancies were resolved by consensus by a third neuroradiologist. The primary judgment criterion was the number of MS spinal cord lesions. Secondary judgment criteria included lesion enhancement, lesion delineation, reader-reported confidence and lesion-to-cord-contrast-ratio. A Wilcoxon's test was used to compare the two datasets. 51 participants were included. 3D-FGAPSIR detected significantly more lesions than the conventional dataset (344 versus 171 respectively, p<0.001). Two participants had no detected lesion on the conventional dataset, whereas 3D-FGAPSIR detected at least one lesion. 3/51 participants had a single enhancing lesion detected by both datasets. Lesion delineation and reader-reported confidence were significantly higher with 3D-FGAPSIR: 4.5 (IQR 1) versus 2 (IQR 0.5), p<0.0001 and 4.5 (IQR 1) versus 2.5 (IQR 0.5), p<0.0001. Lesion-to-cord-contrast-ratio was significantly higher using 3D-FGAPSIR as opposed to 3D-STIR and T2: 1.4 (IQR 0,3) versus 0.4 (IQR 0,1) and 0.3 (IQR 0,1)(p = 0.04). Correlations with clinical data and inter- and intra-observer agreements were higher with 3D-FGAPSIR. 3D-FGAPSIR improved overall MS spinal cord lesion detection as compared to conventional set and detected all enhancing lesions.

Low tesla MRI in acute spinal injuries: a study in a teaching hospital

Background: Early detection of spinal cord lesions in patients of suspected acute spinal injury leads to better prognosis. MRI has become a standard technique for evaluating spinal injuries and especially helpful for diagnosing acute compression of the spinal cord and cord oedema. This study was conducted to evaluate the low tesla MRI findings in cases of suspected acute spinal injuries. Methods: 120 patients with a suspected history of spinal injury who came into the emergency ward of our hospital were included into the study. MRI was done for all the patients within 2 days of admission. Results: The most common age group to be affected was 21-40 years with 48%followed by 41-60 years with 34% being affected. 46% of the patients had cervical injuries, 24% had dorsolumbar and lumbar injuries were seen in 17% of the patients. Spinal cord injuries was seen in 73 of the patients, out of which 64 patients had cord edema,7 with cord haemorrhage and 2 had cord transection. Conclusions: 0.3T MRI was able to identify cord compression and swelling, traumatic disc herniation’s, epidural hematoma, soft tissue injuries, and prevertebral/paravertebral hematoma, while MR imaging was unsatisfactory in identifying small fractures especially of posterior elements.

Creating a STIR—MRI sequence improves detection of spinal cord lesions

Creating a STIR—MRI sequence improves detection of spinal cord lesions

Spinal cord MRI using multi‐array coils and fast spin echo

We performed MRI of brain and spinal cord on 80 patients with multiple sclerosis (MS). Using multi-array coils and fast spin echo, 139 intrinsic lesions were identified in 59 patients (74%). Lesions were more common in the cervical than in the thoracic cord. Cross-sectional areas of the cord, measured from axial images at four levels, showed atrophy in 40%. Clinical disability correlated with cord atrophy but not with cord lesion load. These results show that the use of multi-array coils and fast spin echo allows rapid and sensitive detection of spinal cord lesions in MS and that the cord is involved in the majority of patients. A lack of association between cord lesions and disability may relate to limitations in MR resolution but also suggests that the mechanisms of disability in MS are complex and multifactorial.