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Published in: European Radiology 2/2013

01-02-2013 | Neuro

Clinical application of multi-contrast 7-T MR imaging in multiple sclerosis: increased lesion detection compared to 3 T confined to grey matter

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

Published in: European Radiology | Issue 2/2013

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Abstract

Objectives

Seven-Tesla MRI demonstrated new pathological features of multiple sclerosis (MS) using T2*-weighted sequences. However, a clinical MRI protocol at 7 T has never been investigated. We evaluated the clinical value of 7-T MRI by investigating the sensitivity of lesion detection compared with 3 T.

Methods

Thirty-eight MS patients and eight healthy controls underwent multi-contrast MRI using 3D T1-weighted (3D-T1w), 2D dual-echo T2-weighted (2D-T2w) and 3D fluid-attenuated inversion recovery (3D-FLAIR) at 3 and 7 T. Images were analysed for focal lesions, which were counted and categorised according to anatomical location. The study was approved by the institutional review board.

Results

Lesion-wise analysis showed increased lesion counts in cortical grey matter (GM) at 7 T of 91, 75 and 238 % for 3D-T1w, 2D-T2w and FLAIR sequences, respectively. Patient-wise analysis confirmed this for 2D-T2w and FLAIR (P < 0.023 and P < 0.001). Seven-Tesla white matter (WM) lesion detection was not increased; 3D-FLAIR even detected significantly more WM lesions at 3 T.

Conclusions

Using a clinical multi-contrast MRI protocol, increased lesion detection was observed in cortical GM but not in WM. Given the clinical relevance of GM abnormalities, this may have consequences for clinical outcome measures, prognostic classification and future diagnostic criteria incorporating GM abnormalities.

Key Points

Standard multi-contrast 7-T magnetic resonance imaging in multiple sclerosis is feasible.
Seven-Tesla MRI detects more cortical grey matter lesions than 3 T.
Seven-Tesla MRI fares no better than 3 T in detecting white matter lesions.
Grey matter abnormalities have high diagnostic and prognostic relevance in MS.
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Metadata
Title
Clinical application of multi-contrast 7-T MR imaging in multiple sclerosis: increased lesion detection compared to 3 T confined to grey matter
Authors
Wolter L. de Graaf
Iris D. Kilsdonk
Alexandra Lopez-Soriano
Jaco J. M. Zwanenburg
Fredy Visser
Chris H. Polman
Jonas A. Castelijns
Jeroen J. G. Geurts
Petra J. W. Pouwels
Peter R. Luijten
Frederik Barkhof
Mike P. Wattjes
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 2/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2619-7

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