Comparison of Double Inversion Recovery and Conventional Magnetic Resonance Brain Imaging in Patients with Multiple Sclerosis and Relations with Disease Disability

Abstract

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system, predominantly affecting the white matter, but also the grey matter. Aim of this study was to detect MS lesions with double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR) and T2-weighted magnetic resonance (MR) techniques and determine the sensitivity of these techniques, and the correlation between the number of lesions and expanded disability state scale (EDSS) scores. Thirty-four patients with MS (20 females and 14 males) were included in this study. DIR and conventional MR (T2-A, FLAIR) sequences were obtained. Lesions were counted and classified as belonging to one of seven anatomical regions: cortical, juxtacortical, deep grey matter, deep white matter, mixed white matter-grey matter, periventricular white matter and infratentorial. The correlation between lesion number and EDSS scores was investigated. DIR images showed more intracortical and mixed white matter-grey matter lesions in comparison with both FLAIR and T2 sequences (p=0, p=0 respectively). There was a significant difference between mean lesion numbers at the juxtacortical region, obtained with DIR and T2-weighted images (p = 0.002). The total number of lesions obtained with all methods was similar. DIR brain imaging had the highest sensitivity in the detection of cortical and mixed white matter - grey matter lesions, compared with FLAIR and T2 sequences. In addition, the lesions obtained with DIR images were more easily visualized.

Diagnostic accuracy of double inversion recovery in delineation of multiple sclerosis lesions and its clinical correlation with expanded disability scoring system

“…However, our results were in contrary with the results done by Geurts et al [10] which detected the highest number of lesions with T2. Regarding mixed white matter-gray matter lesions, our study was consistent with the reported results of Vural et al [1].…”

“…Multiple sclerosis (MS) is the most frequent chronic demyelinating disorder of the central nervous system [1]. Not only it affects mainly the white matter (WM) but also it affects parts of the gray matter (GM) [2].…”

3D-DIR for early differential diagnostic and prognostic evaluation of NMO

“…In recent years, 3D-DIR has been gradually applied in the diagnosis of epilepsy, MS and other diseases, and the effects have proven to be satisfactory (4–6). …”

Pre- and Postcontrast 3D Double Inversion Recovery Sequence in Multiple Sclerosis: A Simple and Effective MR Imaging Protocol

“…Additionally, inflammatory lesions remain unsuppressed and appear hyperintense. The studies concluded that DIR is very sensitive and specific for MS lesions in the brain, [3][4][5] especially for intracortical lesions. [6][7][8] One group could also show that DIR provides the highest sensitivity in the detec-tion of MS lesions in the infratentorial region compared with FLAIR and T2WI.…”