PMID- 27056424
OWN - NLM
STAT- MEDLINE
DCOM- 20171121
LR  - 20180828
IS  - 1936-959X (Electronic)
IS  - 0195-6108 (Linking)
VI  - 37
IP  - 8
DP  - 2016 Aug
TI  - Evaluation of Focal Cervical Spinal Cord Lesions in Multiple Sclerosis:
      Comparison of White Matter-Suppressed T1 Inversion Recovery Sequence versus
      Conventional STIR and Proton Density-Weighted Turbo Spin-Echo Sequences.
PG  - 1561-6
LID - 10.3174/ajnr.A4761 [doi]
AB  - BACKGROUND AND PURPOSE: Conventional MR imaging of the cervical spinal cord in MS
      is challenged by numerous artifacts and interreader variability in lesion counts.
      This study compares the relatively novel WM-suppressed T1 inversion recovery
      sequence with STIR and proton density-weighted TSE sequences in the evaluation of
      cervical cord lesions in patients with MS. MATERIALS AND METHODS: Retrospective
      blinded analysis of cervical cord MR imaging examinations of 50 patients with MS 
      was performed by 2 neuroradiologists. In each patient, the number of focal
      lesions and overall lesion conspicuity were measured in the STIR/proton
      density-weighted TSE and WM-suppressed T1 inversion recovery sequence groups.
      Independent side-by-side comparison was performed to categorize the discrepant
      lesions as either "definite" or "spurious." Lesion contrast ratio and edge
      sharpness were independently calculated in each sequence. RESULTS: Substantial
      interreader agreement was noted on the WM-suppressed T1 inversion recovery
      sequence (kappa = 0.82) compared with STIR/proton density-weighted TSE (kappa =
      0.52). Average lesion conspicuity was better on the WM-suppressed T1 inversion
      recovery sequence (conspicuity of 3.1/5.0 versus 3.7/5.0, P < .01, in the
      WM-suppressed T1 inversion recovery sequence versus STIR/proton density-weighted 
      TSE, respectively). Spurious lesions were more common on STIR/proton
      density-weighted TSE than on the WM-suppressed T1 inversion recovery sequence (23
      and 30 versus 3 and 4 by readers 1 and 2, respectively; P < .01). More "definite"
      lesions were missed on STIR/proton density-weighted TSE compared with the
      WM-suppressed T1 inversion recovery sequence (37 and 38 versus 3 and 6 by readers
      1 and 2, respectively). Lesion contrast ratio and edge sharpness were highest on 
      the WM-suppressed T1 inversion recovery sequence. CONCLUSIONS: There is better
      interreader consistency in the lesion count on the WM-suppressed T1 inversion
      recovery sequence compared with STIR/proton density-weighted TSE sequences. The
      focal cord lesions are visualized with better conspicuity due to better contrast 
      ratio and edge sharpness. There are fewer spurious lesions on the WM-suppressed
      T1 inversion recovery sequence compared with STIR/proton density-weighted TSE.
      The WM-suppressed T1 inversion recovery sequence could potentially be substituted
      for either STIR or proton density-weighted TSE sequences in routine clinical
      protocols.
CI  - (c) 2016 by American Journal of Neuroradiology.
FAU - Sundarakumar, D K
AU  - Sundarakumar DK
AUID- ORCID: 0000-0003-2261-8971
AD  - From the Department of Radiology, University of Washington, Seattle, Washington. 
      dineshs@uw.edu.
FAU - Smith, C M
AU  - Smith CM
AUID- ORCID: 0000-0002-8863-1020
AD  - From the Department of Radiology, University of Washington, Seattle, Washington.
FAU - Hwang, W D
AU  - Hwang WD
AUID- ORCID: 0000-0003-0525-4512
AD  - From the Department of Radiology, University of Washington, Seattle, Washington.
FAU - Mossa-Basha, M
AU  - Mossa-Basha M
AUID- ORCID: 0000-0001-7798-8158
AD  - From the Department of Radiology, University of Washington, Seattle, Washington.
FAU - Maravilla, K R
AU  - Maravilla KR
AUID- ORCID: 0000-0001-9188-5374
AD  - From the Department of Radiology, University of Washington, Seattle, Washington.
LA  - eng
PT  - Journal Article
DEP - 20160407
PL  - United States
TA  - AJNR Am J Neuroradiol
JT  - AJNR. American journal of neuroradiology
JID - 8003708
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Artifacts
MH  - Cervical Cord/*diagnostic imaging/pathology
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/*diagnostic imaging/pathology
MH  - Neuroimaging/*methods
MH  - Retrospective Studies
MH  - White Matter/diagnostic imaging/pathology
EDAT- 2016/04/09 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/04/09 06:00
PHST- 2015/10/01 00:00 [received]
PHST- 2016/02/02 00:00 [accepted]
PHST- 2016/04/09 06:00 [entrez]
PHST- 2016/04/09 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
AID - ajnr.A4761 [pii]
AID - 10.3174/ajnr.A4761 [doi]
PST - ppublish
SO  - AJNR Am J Neuroradiol. 2016 Aug;37(8):1561-6. doi: 10.3174/ajnr.A4761. Epub 2016 
      Apr 7.