Multicontrast MR Imaging at 7T in Multiple Sclerosis: Highest Lesion Detection in Cortical Gray Matter with 3D-FLAIR

Kilsdonk, Iris D.; Graaf, Wolter L. de; Soriano, Alexandra; Zwanenburg, Jaco J.M.; Visser, Fredy; Kuijer, Joost P.A.; Geurts, Jeroen J. G.; Pouwels, Petra J. W.; Polman, Chris H.; Castelijns, Jonas A.; Luijten, Peter R.; Barkhof, Frederik; Wattjes, Mike P.

doi:10.3174/ajnr.a3289

Cited by 61 publications

(53 citation statements)

References 38 publications

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“…18 This finding was supported by another study in which DIR detected 43% more cortical lesions than FLAIR. 9 However, a study from Kilsdonk et al 28 at ultra-high-field strength (7T) showed that FLAIR detected 89% more cortical lesions than DIR, and that DIR and T2WI obtained nearly identical mean cortical lesion counts (115 versus 116). This finding indicates that a sequence that may be optimal at a lower field strength (DIR at 3T) may lose its benefit at a higher field strength (7T), and vice versa: A sequence suboptimal at a lower field strength may have an advan- Note:-WM-WML indicates white matter-to-white matter lesion CNR; GM-GML, gray matter-to-gray matter lesion CNR; GM-WM, gray matter-to-white matter CNR.…”

Section: Discussionmentioning

confidence: 99%

Ultra-High-Field MRI Visualization of Cortical Multiple Sclerosis Lesions with T2 and T2*: A Postmortem MRI and Histopathology Study

Jonkman

Klaver

Fleysher³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: At 7T MR imaging, T2*-weighted gradient echo has been shown to provide high-resolution anatomic images of gray matter lesions. However, few studies have verified T2*WI lesions histopathologically or compared them with more standard techniques at ultra-high-field strength. This study aimed to determine the sensitivity of T2WI and T2*WI sequences for detecting cortical GM lesions in MS.

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Section: Discussionmentioning

confidence: 99%

Ultra-High-Field MRI Visualization of Cortical Multiple Sclerosis Lesions with T2 and T2*: A Postmortem MRI and Histopathology Study

Jonkman

Klaver

Fleysher³

et al. 2015

AJNR Am J Neuroradiol

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“…Imaging sensitive to cortical lesions has revealed their absence in NMO (excluding one Japanese study of NMO pathology 48 ), whereas they are seen in the majority of patients with MS. 49,50 Characteristic MS brain lesions surround central venule in .80% on high-strength MRI. 50,51 In NMO lesions, this is less frequent, reported in 9% to 35% of cases 50,52 and likely indicates the different pathogenic mechanisms of the disease.…”

Section: Comparing the Imaging Of Nmosd Withmentioning

confidence: 99%

MRI characteristics of neuromyelitis optica spectrum disorder

et al. 2015

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Since its initial reports in the 19th century, neuromyelitis optica (NMO) had been thought to involve only the optic nerves and spinal cord. However, the discovery of highly specific antiaquaporin-4 antibody diagnostic biomarker for NMO enabled recognition of more diverse clinical spectrum of manifestations. Brain MRI abnormalities in patients seropositive for anti-aquaporin-4 antibody are common and some may be relatively unique by virtue of localization and configuration. Some seropositive patients present with brain involvement during their first attack and/or continue to relapse in the same location without optic nerve and spinal cord involvement. Thus, characteristics of brain abnormalities in such patients have become of increased interest. In this regard, MRI has an increasingly important role in the differential diagnosis of NMO and its spectrum disorder (NMOSD), particularly from multiple sclerosis. Differentiating these conditions is of prime importance because early initiation of effective immunosuppressive therapy is the key to preventing attack-related disability in NMOSD, whereas some disease-modifying drugs for multiple sclerosis may exacerbate the disease. Therefore, identifying the MRI features suggestive of NMOSD has diagnostic and prognostic implications. We herein review the brain, optic nerve, and spinal cord MRI findings of NMOSD. Neuromyelitis optica (NMO) is an inflammatory disease of the CNS that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM). 1The past decade has witnessed dramatic advances in our understanding of NMO. Such advances were initiated by the discovery of the disease-specific autoantibody, NMO-immunoglobulin G (NMO-IgG), and subsequent identification of the main target autoantigen, aquaporin-4 (AQP4), which has distinguished NMO as a distinct disease from multiple sclerosis (MS). 2Current diagnostic criteria, however, still require both ON and myelitis for an NMO diagnosis.3 Nevertheless, the identification of anti-AQP4 antibodies beyond the current diagnostic criteria of NMO indicates a broader clinical phenotype of this disorder, so-called "NMO spectrum disorder" (NMOSD). 4,5 The NMOSD encompasses anti-AQP4 antibody seropositive patients with limited or inaugural forms of NMO and with specific brain abnormalities. It also includes anti-AQP4 antibody seropositive patients with other autoimmune disorders such as systemic

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“…8). 43,44 Cortical lesions are rather specific for multiple sclerosis (MS), and they occur in the earliest stages of the disease. 50 It is clinically important to make cortical lesions visible in vivo by clinical 3D MR imaging.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…For 3D-FLAIR, there are many reports regarding application to multiple sclerosis. 5,6,[42][43][44][45][46][47][48][49][50][51][52][53][54] Smaller lesions can be detected by 3D-FLAIR than by 2D-FLAIR due to thinner slices and fewer flow artifacts with 3D-FLAIR. 45,46 Excellent detection of cortical lesions by 3D-FLAIR has also been reported (Fig.…”

Section: Clinical Applicationsmentioning

confidence: 99%

The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

Naganawa

2015

magn reson med sci

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In clinical MR neuroimaging, 3D fluid-attenuated inversion recovery (3D-FLAIR) with a variable-flip-angle turbo spin echo sequence is becoming popular. There are more than 100 reports regarding 3D-FLAIR in the PubMed database. In this article, the technical and clinical features of 3D-FLAIR for neuroimaging are reviewed and summarized. 3D-FLAIR allows thinner slices with multi-planar reformation capability, a higher flow sensitivity, high sensitivity to subtle T 1 changes in fluid, images without cerebrospinal fluid (CSF) inflow artifacts, and a 3D dataset compatible with computer-aided analysis. In addition, 3D-FLAIR can be obtained within a clinically reasonable scan time. It is important for radiologists to be familiar with the features of 3D-FLAIR and to provide useful information for patients.

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Multicontrast MR Imaging at 7T in Multiple Sclerosis: Highest Lesion Detection in Cortical Gray Matter with 3D-FLAIR

Cited by 61 publications

References 38 publications

Ultra-High-Field MRI Visualization of Cortical Multiple Sclerosis Lesions with T2 and T2*: A Postmortem MRI and Histopathology Study

Ultra-High-Field MRI Visualization of Cortical Multiple Sclerosis Lesions with T2 and T2*: A Postmortem MRI and Histopathology Study

MRI characteristics of neuromyelitis optica spectrum disorder

The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

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