A comparison of the sensitivity of monthly unenhanced and enhanced MRI techniques in detecting new multiple sclerosis lesions

M. Filippi, S. Bastianello, M. Rovaris, [No Value] Mastronardo, C. Gasperini, G. Comi

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Abstract

In this longitudinal study, the sensitivities of four magnetic resonance imaging techniques for detecting the appearance of new lesions in multiple sclerosis (MS) were evaluated and compared. Dual echo conventional spin-echo (CSE), fast fluidattenuated inversion recovery (fast-FLAIR) and post-contrast Tl-weighted scans Were obtained on four occasions each separated by 28 days from 18 patients with relapsing-remitting MS using a 1.5 Tesla machine. Dual-echo fast spin-echo (FSE) scans were also obtained from five of them. New lesions seen using each sequence during the follow-up were counted by agreement by four observers in two stages (stage 1: random review of complete sets of scans from each technique; stage 2: side-by-side review with a 'retrospective' count of new lesions). At stage 1, 1.44 new lesions per patient per month were detected on CSE scans, 1. on fast-FLAIR 88 (31% more than CSE) and 2.07 on post-contrast Tl-weighted scans (44% more than CSE) (p=0.03). Differences were, however, reduced after stage 2: fast-FLAIR detected 29% and post-contrast Tlweighted scans detected 31% more new lésions than CSE (p=0.08). The combination of fast-FLAIR and post-contrast scans detected about 8% more lesions than the usual combination of CSE and post-contrast scans (144 ys 133 new lesions). In the five patients also with FSE scans, this technique detected a number of new lesions intermediate between CSE and fasf-FLAIR. This study indicates that enhanced MRI remains the most sensitive method to detect 'active' lesions in MS and that CSE can be substituted by fast-FLAIR or FSE when monitoring short-term disease activity in MS, either natural or modified by treatment.

Original languageEnglish
Pages (from-to)40
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

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ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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