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Abstract Details

Determining the Effectiveness of Double Inversion Recovery (DIR) Brain MRI Sequence in Detecting Upper Spinal Cord Lesions in Multiple Sclerosis Patients
Multiple Sclerosis
P1 - Poster Session 1 (9:00 AM-5:00 PM)
284

This study explores the efficacy of brain MRI in detecting upper spinal cord lesions in Multiple Sclerosis (MS) patients.

Magnetic Resonance Imaging (MRI) plays a key role in diagnosing MS, determining progression of disease, and monitoring response to treatment. The standard of care for MS diagnosis includes MRI of the brain and less frequently MRI of the spinal cord, however the MRI of the upper cervical spine has a prognostic value in the risk of developing full MS in patients with early MS.

Double Inversion Recovery (DIR) is a pulse sequence which allows for detection of highly conspicuous lesions in both the cortex and in white matter. While many studies have extensively investigated the ability of DIR in detecting brain lesions, our current understanding of its utility in detecting cervical spinal cord lesions is limited.

This is a retrospective study of 64 MS patients. Two providers with extensive experience of assessing MRI of MS patients independently carried out blinded readings of brain DIR images, which reliably included the C1-C4 levels of the spinal cord. Later, consensus reads were performed in cases of disagreement. The presence or absence of lesions and the level of the lesions within the cervical spinal cord were noted. These presumptive lesions were then compared to those in the corresponding official cervical spine MRI reports to determine sensitivity of brain DIR in detecting cervical spinal cord lesions. 

Out of 48 lesions identified on official cervical spine MRI reports, 42 were identified in the brain DIR blinded reading process, yielding a sensitivity of 87.5%. Also, 20 more lesions (~42%) were identified in the brain DIR than in the official MRI reports.

Brain Double Inversion Recovery has value in detecting cervical spine lesions in MS patients and demonstrates increased detection of MS lesions than conventional T2 imaging.
Authors/Disclosures

PRESENTER 		No disclosure on file
Jaime Imitola, MD, FAAN (UConn Health MS center) The institution of Dr. Imitola has received research support from Genentech. Dr. Imitola has a non-compensated relationship as a Board Member with National MS Society that is relevant to AAN interests or activities. Dr. Imitola has a non-compensated relationship as a Committee Member with International Society for Stem Cell Research that is relevant to AAN interests or activities.
Leo Wolansky, MD The institution of Dr. Wolansky has received research support from Guerbet.