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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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
Issue number4
Publication statusPublished - 1997


ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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