Format

Send to

Choose Destination
Eur Radiol. 2017 Feb;27(2):637-641. doi: 10.1007/s00330-016-4416-1. Epub 2016 May 27.

Altered signal intensity of active enhancing inflammatory lesions using post-contrast double inversion recovery MR sequence.

Author information

1
Departments of Neuroradiology, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France. jerome.hodel@gmail.com.
2
Faculty of Medicine, Université Paris Est Créteil, Créteil, France. jerome.hodel@gmail.com.
3
CHU Lille, Department of Neuroradiology, F-59000, Lille, France. jerome.hodel@gmail.com.
4
CHU Lille, Department of Neuroradiology, F-59000, Lille, France.
5
Uniersity of Lille, CHU Lille, LIRIC - INSERM U995, FHU Imminent, F-59000, Lille, France.
6
Philips, Suresnes, France.
7
Inserm, U1018, Radiation Epidemiology Team, Villejuif, France.
8
University of Lille, CHU Lille, INSERM U1171, FHU VasCog, F-59000, Lille, France.

Abstract

OBJECTIVES:

We aimed at establishing the impact upon gadolinium administration on the conspicuity of active enhancing multiple sclerosis (MS) lesions using double inversion recovery (DIR) at 3T.

METHODS:

15 consecutive patients with MS (n=8) or a clinically isolated syndrome (n=7) underwent pre and post-contrast DIR in addition to T2-weighted, FLAIR, pre and post-contrast T1-weighted sequences. First, two neuroradiologists located and marked all the enhancing MS lesions visible in consensus. Second, two other neuroradiologists, blinded to other sequences than DIR, independently assessed the SI changes from pre to post-contrast DIR images for each enhancing lesion, according to a 4-point-scale: increased SI (grade 1), absence of change (grade 2), lesion being partially (grade 3) or completely masked on post-contrast DIR images (grade 4).

RESULTS:

246 MS lesions were detected including 26 enhancing on post-contrast T1-weighted images in 9 patients. The two blinded readers concluded to a decreased signal-intensity on post-contrast DIR images for all the 26 enhancing MS lesions (14 of grade 3 and 12 of grade 4). Inter-observer agreement was excellent, Kappa=0.85 (0.75 - 0.94). Using DIR post-contrast leads to altered signal-intensity of enhancing active MS lesions, ranging from partial to complete signal-loss.

CONCLUSION:

Our study strongly suggests the use of DIR before gadolinium administration.

KEY POINTS:

• DIR has gained widespread use in MS. • MRI protocols for MS patients usually contain several post-contrast sequences. • Signal-intensity of enhancing MS lesions is altered using DIR post-contrast. • Our study strongly suggests the use of DIR before gadolinium administration.

KEYWORDS:

Active enhancing inflammatory lesions; Clinically isolated syndrome; Double inversion recovery MR sequence; Gadolinium-based contrast agent; Multiple sclerosis

PMID:
27229340
DOI:
10.1007/s00330-016-4416-1
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center