Evaluation of plaque detection and optimum time of enhancement in acute attack multiple sclerosis after contrast injection

Hashemi, Hassan; Behzadi, Somayeh; Harirchian, Mohammad Hossein; Yaghoobi, Mahboobeh; Shakiba, Madjid; Jalali, Amir Hossein; Firouznia, Kavous

doi:10.1177/0284185113495831

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Despite the different techniques that have been reported for identifying more enhancing lesions in brain MR images of MS patients, an adequate MR protocol may increase imaging sensitivity and specificity without additional costs or time. The sensitivity of a delayed post-contrast T1 sequence acquisition has been reported to be higher than that of early acquisition 7 . We performed a routine intravenous contrast injection before the acquisition of T2 and FLAIR sequences, which added approximately ten minutes for the T1WI post-contrast acquisition without an appreciable loss of T2 signal characteristics.…”

Section: A B C Discussionmentioning

confidence: 99%

“…Selection of the most appropriate T1-weighted image (T1WI) acquisition after intravenous contrast administration remains a matter of debate. Recent literature has defined some alternatives for increasing the sensitivity of contrast enhancement on MRI acquisitions by either increasing the concentration of Gd in the tissues through increasing the injected dose or by using a delayed T1WI acquisition 6,7,8,9 . However, all these alternatives increase both costs and/or timing, in addition to the risks of using an exogenous substance such as Gd 10 .…”

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confidence: 99%

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Improving acute demyelinating lesion detection: which T1-weighted magnetic resonance acquisition is more sensitive to gadolinium enhancement?

Amaral

Fragoso

Rocha

2019

Arq. Neuro-Psiquiatr.

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Because of the need for a standardized and accurate method for detecting multiple sclerosis (MS) inflammatory activity, different magnetic resonance (MR) acquisitions should be compared in order to choose the most sensitive sequence for clinical routine. Objective: To compare the sensitivity of a T1-weighted image to a single dose of gadolinium (Gd) administration both with and without magnetization transfer to detect contrast enhancement in active demyelinating focal lesions. Methods: A sample of relapsing-remitting MS patients were prospectively examined separately by two neuroradiologists using a 1.5 Tesla scanner. The outcome parameters were focused on Gd-enhancement detection attributed to acute demyelination. All MR examinations with at least one Gd-enhancing lesion were considered positive (MR+) and each lesion was analyzed according to its size and contrast ratio. Results: Thirty-six MR examinations were analyzed with a high inter-observer agreement for MR+ detection (k coefficient > 0.8), which was excellent for the number of Gd-enhancing lesions (0.91 T1 spin-echo (SE), 0.88 T1 magnetization transfer contrast (MTC) sequence and 0.99 magnetization-prepared rapid acquisition with gradient-echo (MPRAGE). Significantly more MR+ were reported on the T1 MTC scans, followed by the T1 SE, and MPRAGE scans. Confidently, the T1 MTC sequence demonstrated higher accuracy in the detection of Gd-enhancing lesions, followed by the T1 SE and MPRAGE sequences. Further comparisons showed that there was a statistically significant increase in the contrast ratio and area of Gd-enhancement on the T1 MTC images when compared with both the SE and MPRAGE images. Conclusion: Single-dose Gd T1 MTC sequence was confirmed to be the most sensitive acquisition for predicting inflammatory active lesions using a 1.5 T magnet in this sample of MS patients. RESUMONo que se refere à necessidade de um método preciso e padronizado para a detecção de atividade inflamatória em esclerose múltipla (EM), diferentes aquisições de RM devem ser comparadas com objetivo de escolher a sequência mais sensível para a rotina clínica. Objetivo: Comparar a sensibilidade das sequências ponderadas em T1 após a administração endovenosa de uma única dose de gadolínio, com e sem a adição da transferência de magnetização, para detectar a impregnação das lesões desmielinizantes focais agudas. Métodos: Uma amostra de pacientes com EM-RR foi prospectivamente avaliada separadamente por dois neurorradiologistas em um equipamento de RM de 1,5 Tesla. Os parâmetros de desfecho foram direcionados para a avaliação da detecção de impregnação pelo Gd atribuída à desmielinização aguda. Todos os exames de RM que demonstraram ao menos uma lesão com impregnação pelo Gd foram considerados positivos (RM+) e cada lesão foi analisada de acordo com suas dimensões e contraste. Resultados: Trinta e seis exames de RM foram analisados. Os avaliadores demonstraram elevada concordância para a detecção de RM+ (coeficiente> 0,8), sendo excelente quanto ao número de lesões com impregnação p...

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Section: A B C Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Improving acute demyelinating lesion detection: which T1-weighted magnetic resonance acquisition is more sensitive to gadolinium enhancement?

Amaral

Fragoso

Rocha

2019

Arq. Neuro-Psiquiatr.

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“…Gadolinium-enhanced brain MRI is a sensitive and standard imaging method for the diagnosis of MS, determination of disease severity in the acute and chronic phases, identification of disease progression, and monitoring treatment response in MS patients (MAGNIMS 2016), (1)(2)(3)5). A suitable contrast agent, an appropriate dose, and an efficient scan time can increase imaging value for the detection of acute phase lesions (4-7).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple sclerosis (MS) is a chronic demyelinating nervous system disease, most commonly affecting young women. In general, MS prevalence has dramatically increased up to 10% in the last five years, affecting 2.3 million people worldwide (1)(2)(3)(4). This disease is usually progressive and disables the patients after a few years (5,6).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Gadovist and Magnevist in brain Magnetic resonance imaging of multiple sclerosis patients with an acute attack

Hashemi

Behzadi

Harirchian

et al. 2021

ircmj

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Objective: The use of an appropriate contrast agent performs a major role in brain magnetic resonance imaging (MRI) of multiple sclerosis (MS) patients. The present study aimed to make a comparison between the diagnostic values of Gadovist and Magnevist considering the successive imaging times in contrast-enhanced brain MRI of MS patients. Materials and Methods: A total of 62 relapsing-remitting MS patients (56 females, mean age of 31 years) were enrolled in the present study. All of them underwent two sessions of standard contrast-enhanced brain MRI upon enrollment and 48 h later. The participants were randomly assigned to each contrast agent. T1-weighted (T1W) images were taken 30 sec, as well as 5, 10, 15, and 30 min after the contrast injection. For all of the images, two neuro-radiologists who were blinded to the contrast type counted the number of plaques in the brain. In addition, for the enhanced plaques larger than 10 mm, the signal intensity (SI) was determined using its region of interest. Results: The mean plaque number significantly increased from 30 sec to 15 min for both contrasts separately (P<0.001). Nonetheless, the slight increases in the mean plaque number from 15-30 min for both Gadovist and Magnevist were not statistically significant (both P-Values>0.25). The mean plaque number in the Gadovist group was higher, compared to that in the Magnevist group at both 15 and 30 min, and the differences were statistically on the borderline (both P-Values=0.07). The mean SI of enhanced plaques gradually increased in the course of imaging in both contrast groups. Except for 30 sec, in all other time sessions, the mean SI was higher in Gadovist-enhanced MR images, compared to Magnevist-enhanced MR images (P<0.01). Conclusion: As evidenced by the obtained results, Gadovist showed a relatively better diagnostic value for brain MRI of MS patients. Furthermore, the findings suggested that it is cost-effective to take MRI only up to 15 min (instead of 30 min) after contrast injection in both agents.

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“…Наиболее информативным инструментальным методом диагностики РС считается МРТ [3,4], которая позволяет визуализировать патологические очаги в ткани мозга [5]. Благодаря этому методу была подтверждена многоочаговость поражения центральной нервной системы при РС [6][7][8][9][10]. Для анализа данных МРТ разработаны соответствующие диагностические критерии (табл.…”

Section: методы исследования и диагностикиunclassified

Contrast agents in MRI-diagnosis of multiple sclerosis

Abakumova

Nukolova

Gusev

et al. 2015

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Magnetic resonance imaging using contrast agents plays an important role in diagnosis and assessment of treatment efficacy in multiple sclerosis. The development of contrast agents on the basis of gadolinium or iron oxide nanoparticles has potential for diagnosis of pathological foci (tumors, amyloid plaques, inflammation and foci of demyelination or necrosis) in nervous system diseases. Newly developing types of diagnostic substances for visualization of pathological foci in multiple sclerosis are presented in this review.

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Evaluation of plaque detection and optimum time of enhancement in acute attack multiple sclerosis after contrast injection

Abstract: The maximum number of enhancing plaques in MS patients was detected 15 min after contrast agent administration and the size and signal intensity of the lesions also increased remarkably at this time.

Cited by 7 publications

References 19 publications

Improving acute demyelinating lesion detection: which T1-weighted magnetic resonance acquisition is more sensitive to gadolinium enhancement?

Improving acute demyelinating lesion detection: which T1-weighted magnetic resonance acquisition is more sensitive to gadolinium enhancement?

Comparison of Gadovist and Magnevist in brain Magnetic resonance imaging of multiple sclerosis patients with an acute attack

Contrast agents in MRI-diagnosis of multiple sclerosis

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