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. 2023 Sep;104(9):401-409.
doi: 10.1016/j.diii.2023.04.009. Epub 2023 May 6.

Improved detection of juxtacortical lesions using highly accelerated double inversion-recovery MRI in patients with multiple sclerosis

Morgane Lespagnol  1 , Aurélien Massire  2 , Imen Megdiche  1 , Fabien Lespagnol  3 , Pierre Brugières  1 , Alain Créange  4 , Alto Stemmer  5 , Blanche Bapst  6
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Free article

Improved detection of juxtacortical lesions using highly accelerated double inversion-recovery MRI in patients with multiple sclerosis

Morgane Lespagnol et al. Diagn Interv Imaging. 2023 Sep.
Free article

Abstract

Purpose: The purpose of this study was to compare a highly-accelerated double inversion recovery (fast-DIR) sequence using a recent parallel imaging technique (CAIPIRINHA) with a conventional DIR (conv-DIR) sequence for image quality and the detection of juxtacortical and infratentorial multiple sclerosis (MS) lesions.

Materials and methods: A total of 38 patients with MS who underwent brain MRI at 3 T between 2020 and 2021 were included. There were 27 women and 12 men with a mean age of 40 ± 12.8 (standard deviation) years (range: 20-59 years). All patients underwent conv-DIR sequence and fast-DIR sequence. Fast-DIR was obtained with a T2-preparation module to improve contrast and an iterative denoising algorithm to compensate noise enhancement. Two blinded readers reported the number of juxtacortical and infratentorial MS lesions for fast-DIR and conv-DIR, confirmed by further consensus reading that was used as the standard of reference. Image quality and contrast were evaluated for fast-DIR and conv-DIR sequences. Comparisons between fast-DIR and conv-DIR sequences were performed using Wilcoxon test and Lin concordance correlation coefficient.

Results: Thirty-eight patients were analyzed. Fast-DIR imaging allowed detection of 289 juxtacortical lesions vs. 238 with conv-DIR, corresponding to a significant improved detection rate with fast-DIR (P < 0.001). Conversely, 117 infratentorial lesions were detected with conv-DIR sequence vs. 80 with fast-DIR sequence (P < 0.001). Inter-observer agreement for lesion detection with fast-DIR and conv-DIR was very high (Lin concordance correlation coefficient ranging between 0.86 and 0.96).

Conclusion: Fast-DIR improves the detection of juxtacortical MS lesions, but is limited for the detection of infratentorial MS lesions.

Keywords: Double inversion recovery; Iterative denoising; Juxtacortical lesions; Magnetic resonance imaging; Multiple sclerosis.

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Conflict of interest statement

Declaration of Competing Interest Aurélien Massire is an employee of Siemens Healthcare SAS and Alto Stemmer is an employee of Siemens Healthcare GmbH. The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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