Abstract Details

Title Multifaceted Evaluation of Double Inversion Recovery Brain MRI in Detection of Cervical Spine Multiple Sclerosis Lesions

Topic Multiple Sclerosis

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-002

Objective

To quantitatively study the efficacy of Brain Double Inversion Recovery (DIR) MRI for the detection of cervical spinal cord lesions in Multiple Sclerosis (MS) patients using blinded readings as well as contrast to noise ratios (C/N).

Background

Background: DIR is a well-established MRI pulse sequence for detection of cerebral cortical and juxtacortical MS lesions. Since the superior half of the cervical cord is visible on sagittally acquired volumetric DIR of the brain, we investigated the efficacy of Brain MRI for detecting upper spinal cord of MS patients.

Design/Methods We retrospectively examined the MRI of the brain of 64 patients with established MS, who had also undergone cervical spine MRI. Two blinded MS expert readers, who assessed the scans for lesion numbers and rated lesion visibility and overall image quality, reviewed brain 3D DIR sagittal and coronal images. Official cervical spine study reports were used as the “gold standard” in this analysis. Additionally, standardized Mean contrast-to-noise ratios (C/N) and standard deviation (S.D.) were calculated in representative lesions for each patient and compared to those of 3D brain FLAIR images.

Results

The sensitivity of brain DIR was found to be 87% and specificity was found to 61% when all “definite” lesions were included. When considering both “probable” and “definite” lesions, the sensitivity increased to 91% and specificity decreased to 54%. Contrast to noise ratio of brain DIR lesions was significantly higher compared to brain FLAIR lesions (7.56 +/-1.77 vs. 0.67+/-1.27).

Conclusions

Sagittally acquired volumetric Brain DIR can provide useful information on cervical spinal cord lesions, with high C/N. In some cases, this should facilitate the attainment of the MRI components of McDonald’s diagnostic criteria without a dedicated cervical spine study.

Authors/Disclosures
Shivam Patel, MD PRESENTER	Mr. Patel has nothing to disclose.
Marina Creed (UConn Health University Medical Grihp)	No disclosure on file
	No disclosure on file
Leo Wolansky, MD	The institution of Dr. Wolansky has received research support from Guerbet.
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.

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