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Cairns J, Vavasour IM, Traboulsee A, Carruthers R, Kolind SH, Li DKB, Moore GRW, Laule C. Diffusely abnormal white matter in multiple sclerosis. J Neuroimaging 2021; 32:5-16. [PMID: 34752664 DOI: 10.1111/jon.12945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 02/06/2023] Open
Abstract
MRI enables detailed in vivo depiction of multiple sclerosis (MS) pathology. Localized areas of MS damage, commonly referred to as lesions, or plaques, have been a focus of clinical and research MRI studies for over four decades. A nonplaque MRI abnormality which is present in at least 25% of MS patients but has received far less attention is diffusely abnormal white matter (DAWM). DAWM has poorly defined boundaries and a signal intensity that is between normal-appearing white matter and classic lesions on proton density and T2 -weighted images. All clinical phenotypes of MS demonstrate DAWM, including clinically isolated syndrome, where DAWM is associated with higher lesion volume, reduced brain volume, and earlier conversion to MS. Advanced MRI metric abnormalities in DAWM tend to be greater than those in NAWM, but not as severe as focal lesions, with myelin, axons, and water-related changes commonly reported. Histological studies demonstrate a primary lipid abnormality in DAWM, with some axonal damage and lesser involvement of myelin proteins. This review provides an overview of DAWM identification, summarizes in vivo and postmortem observations, and comments on potential pathophysiological mechanisms, which may underlie DAWM in MS. Given the prevalence and potential clinical impact of DAWM, the number of imaging studies focusing on DAWM is insufficient. Characterization of DAWM significance and microstructure would benefit from larger longitudinal and additional quantitative imaging efforts. Revisiting data from previous studies that included proton density and T2 imaging would enable retrospective DAWM identification and analysis.
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Affiliation(s)
- James Cairns
- Department of Medicine (Neurology), University of British Columbia, British Columbia, Vancouver, Canada.,Department of Radiology, University of British Columbia, British Columbia, Vancouver, Canada
| | - Irene M Vavasour
- Department of Radiology, University of British Columbia, British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, British Columbia, Vancouver, Canada
| | - Anthony Traboulsee
- Department of Medicine (Neurology), University of British Columbia, British Columbia, Vancouver, Canada
| | - Robert Carruthers
- Department of Medicine (Neurology), University of British Columbia, British Columbia, Vancouver, Canada
| | - Shannon H Kolind
- Department of Medicine (Neurology), University of British Columbia, British Columbia, Vancouver, Canada.,Department of Radiology, University of British Columbia, British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, British Columbia, Vancouver, Canada.,Department of Physics & Astronomy, University of British Columbia, British Columbia, Vancouver, Canada
| | - David K B Li
- Department of Medicine (Neurology), University of British Columbia, British Columbia, Vancouver, Canada.,Department of Radiology, University of British Columbia, British Columbia, Vancouver, Canada
| | - G R Wayne Moore
- Department of Medicine (Neurology), University of British Columbia, British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, British Columbia, Vancouver, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, British Columbia, Vancouver, Canada
| | - Cornelia Laule
- Department of Radiology, University of British Columbia, British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, British Columbia, Vancouver, Canada.,Department of Physics & Astronomy, University of British Columbia, British Columbia, Vancouver, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, British Columbia, Vancouver, Canada
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Vertinsky AT, Li DK, Vavasour IM, Miropolsky V, Zhao G, Zhao Y, Riddehough A, Moore GW, Traboulsee A, Laule C. Diffusely Abnormal White Matter, T2
Burden of Disease, and Brain Volume in Relapsing-Remitting Multiple Sclerosis. J Neuroimaging 2018; 29:151-159. [DOI: 10.1111/jon.12574] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/09/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Alexandra T. Vertinsky
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
| | - David K.B. Li
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
| | - Irene M. Vavasour
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
| | - Vladislav Miropolsky
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
| | - Guojun Zhao
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
| | - Yinshan Zhao
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
| | - Andrew Riddehough
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
| | - G.R. Wayne Moore
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver British Columbia Canada
| | - Anthony Traboulsee
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
| | - Cornelia Laule
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver British Columbia Canada
- Department of Physics and Astronomy; University of British Columbia; Vancouver British Columbia Canada
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Bagnato F, Ohayon JM, Ehrmantraut M, Chiu AW, Riva M, Ikonomidou VN. Clinical and imaging metrics for monitoring disease progression in patients with multiple sclerosis. Expert Rev Neurother 2014; 6:599-612. [PMID: 16623658 DOI: 10.1586/14737175.6.4.599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune disease of the CNS leading to clinical disability in 250,000-350,000 young adults in the USA and Europe. The disease affects both white matter (WM) and gray matter (GM) tissues of the brain and spinal cord. While WM disease is easily quantified using currently available magnetic resonance imaging (MRI) techniques, identification and quantification of GM disease present a daily challenge. Nonconventional brain and spinal cord MRI techniques, including magnetization transfer, MRI spectroscopy and diffusion tensor imaging, have improved our understanding of MS pathology in the deep GM. The sensitivity of high-resolution MRI obtained at a high magnetic field will improve the detection of spinal cord and brain cortical GM disease. The appropriate use of the above-mentioned techniques has the potential to more accurately explain the level of disability in MS patients.
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Affiliation(s)
- Francesca Bagnato
- Neuroimmunology Branch, NIND-NIH, 10 Center Drive, Building 10, Room 5B16, Bethesda, MD 20892-1400, USA.
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Kilsdonk ID, de Graaf WL, Barkhof F, Wattjes MP. Inflammation high-field magnetic resonance imaging. Neuroimaging Clin N Am 2012; 22:135-57, ix. [PMID: 22548925 DOI: 10.1016/j.nic.2012.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Multiple sclerosis (MS) is the most common inflammatory demyelinating disorder of the central nervous system (CNS). MS has been subject to high-field magnetic resonance (MR) imaging research to a great extent during the past years, and much data has been collected that might be helpful in the investigation of other inflammatory CNS disorders. This article reviews the value of high-field MR imaging in examining inflammatory MS abnormalities. Furthermore, possibilities and challenges for the future of high-field MR imaging in MS are discussed.
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Affiliation(s)
- Iris D Kilsdonk
- Department of Radiology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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5
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Lunde Larsen LS, Larsson HBW, Frederiksen JL. The value of conventional high-field MRI in MS in the light of the McDonald criteria: a literature review. Acta Neurol Scand 2010; 122:149-58. [PMID: 20597869 DOI: 10.1111/j.1600-0404.2010.01403.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The diagnosis of MS is based on the revised McDonald criteria and is multidisciplinary. Both clinical and paraclinical measures are included. High-field magnetic resonance imaging (MRI) is becoming increasingly available and it is therefore necessary to clarify possible advantages of high-field MRI in MS. The aim of this paper was to review MRI studies in MS where a direct comparison of MRI at high field with MRI at 1-1.5 tesla (T) had been performed. The studies evaluated were found by searching Pubmed with relevant terms including MeSH terms. The reviewed studies all found the conspicuity of lesions to be better at high field. Of the seven studies, six found more and bigger lesions at high-field MRI. In the present paper, the relevant MRI sequences are evaluated in detail. The detection of more lesions at high-field strength did not seem to lead to earlier diagnosis of clinically definite multiple sclerosis. Further larger studies of patients with clinically isolated syndromes are needed to settle the question of a diagnostic consequence of high-field imaging in MS. We suggest that the next revision of the McDonald diagnostic criteria include a recommendation of field strength.
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Affiliation(s)
- L S Lunde Larsen
- Optic Neuritis Research Department, Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark.
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6
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Di Perri C, Dwyer MG, Wack DS, Cox JL, Hashmi K, Saluste E, Hussein S, Schirda C, Stosic M, Durfee J, Poloni GU, Nayyar N, Bergamaschi R, Zivadinov R. Signal abnormalities on 1.5 and 3 Tesla brain MRI in multiple sclerosis patients and healthy controls. A morphological and spatial quantitative comparison study. Neuroimage 2009; 47:1352-62. [DOI: 10.1016/j.neuroimage.2009.04.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 03/31/2009] [Accepted: 04/01/2009] [Indexed: 10/20/2022] Open
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Wattjes MP, Barkhof F. High field MRI in the diagnosis of multiple sclerosis: high field-high yield? Neuroradiology 2009; 51:279-92. [PMID: 19277621 DOI: 10.1007/s00234-009-0512-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Accepted: 02/11/2009] [Indexed: 10/21/2022]
Abstract
Following the approval of the U.S. Food and Drug Administration (FDA), high field magnetic resonance imaging (MRI) has been increasingly incorporated into the clinical setting. Especially in the field of neuroimaging, the number of high field MRI applications has been increased dramatically. Taking advantage on increased signal-to-noise ratio (SNR) and chemical shift, higher magnetic field strengths offer new perspectives particularly in brain imaging and also challenges in terms of several technical and physical consequences. Over the past few years, many applications of high field MRI in patients with suspected and definite multiple sclerosis (MS) have been reported including conventional and quantitative MRI methods. Conventional pulse sequences at 3 T offers higher lesion detection rates when compared to 1.5 T, particularly in anatomic regions which are important for the diagnosis of patients with MS. MR spectroscopy at 3 T is characterized by an improved spectral resolution due to increased chemical shift allowing a better quantification of metabolites. It detects significant axonal damage already in patients presenting with clinically isolated syndromes and can quantify metabolites of special interest such as glutamate which is technically difficult to quantify at lower field strengths. Furthermore, the higher susceptibility and SNR offer advantages in the field of functional MRI and diffusion tensor imaging. The recently introduced new generation of ultra-high field systems beyond 3 T allows scanning in submillimeter resolution and gives new insights into in vivo MS pathology on MRI. The objectives of this article are to review the current knowledge and level of evidence concerning the application of high field MRI in MS and to give some ideas of research perspectives in the future.
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Affiliation(s)
- Mike P Wattjes
- MS Center Amsterdam, Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
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Nielsen K, Rostrup E, Frederiksen JL, Knudsen S, Mathiesen HK, Hanson LG, Paulson OB. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla. Invest Radiol 2006; 41:76-82. [PMID: 16428976 DOI: 10.1097/01.rli.0000188364.76251.28] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recovery (FLAIR), proton density and T2-weighted turbo spin echo, and T1-weighted spin echo after contrast. In addition, magnetization-prepared rapid acquisition gradient echo (MPRAGE) was obtained after contrast at 3.0 T. Lesion number and volumes were assessed by an observer blind to patient identity and field strength. RESULTS Scans at 3.0 T showed a significantly increase in number of lesions detected on FLAIR images (P = 0.002) relative to scanning at 1.5 T. MPRAGE proved to be suitable for detecting enhancing lesions in ON. CONCLUSION The MRI protocol at 3.0 T was more sensitive to hyperintense brain lesions in ON than the standard MRI protocol at 1.5 T.
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Affiliation(s)
- Kirsten Nielsen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark.
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9
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Wattjes MP, Lutterbey GG, Harzheim M, Gieseke J, Träber F, Klotz L, Klockgether T, Schild HH. Higher sensitivity in the detection of inflammatory brain lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis using high field MRI: an intraindividual comparison of 1.5 T with 3.0 T. Eur Radiol 2006; 16:2067-73. [PMID: 16649033 DOI: 10.1007/s00330-006-0195-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 01/16/2006] [Accepted: 02/03/2006] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to determine the sensitivities in the detection of inflammatory lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis at 3.0 T and 1.5 T. MR imaging of 40 patients at both field strengths was performed in separate sessions including contiguous axial slices of T2 turbo spin-echo (T2 TSE), fluid-attenuated-inversion-recovery (FLAIR) and pre- and postcontrast T1 spin-echo (T1 SE). Inflammatory lesions > 3 mm in size were counted and categorized according to their anatomic location. Lesion conspicuity was assessed on a five-point scale. At 3.0 T, 13% more white matter lesions could be identified on the FLAIR sequence and on the T2 TSE sequence. Compared to 1.5 T 7.5% more contrast-enhancing lesions were detected at 3.0 T. The higher detection rate at 3.0 T was significant for the infratentorial (p = 0.02) and juxtacortical (p < 0.01) region on the FLAIR as well as for the infratentorial (p = 0.03), juxtacortical (p = 0.02) and periventricular (p = 0.03) region on the T2 TSE sequence. The lesion conspicuity was significantly better at 3.0 T for FLAIR and T2 TSE sequences (p<0.01; p=0.01). In conclusion, high-field MRI at 3.0 T provides a significantly higher detection rate of inflammatory brain lesions especially in the infratentorial, juxtacortical and periventricular anatomic region.
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Affiliation(s)
- Mike P Wattjes
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
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10
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Wattjes MP, Lutterbey GG, Harzheim M, Gieseke J, Träber F, Klotz L, Klockgether T, Schild HH. Imaging of inflammatory lesions at 3.0 Tesla in patients with clinically isolated syndromes suggestive of multiple sclerosis: a comparison of fluid-attenuated inversion recovery with T2 turbo spin-echo. Eur Radiol 2006; 16:1494-500. [PMID: 16550354 DOI: 10.1007/s00330-005-0082-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Revised: 09/13/2005] [Accepted: 11/08/2005] [Indexed: 11/30/2022]
Abstract
The aims of this study were to determine and compare the sensitivity of T2 turbo spin-echo (T2 TSE) and fluid-attenuated inversion recovery (FLAIR) sequences at 3.0 T in the detection of inflammatory lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis. Forty-nine patients were examined with a 3.0 T MRI system using 5 mm axial sections of T2 TSE (2:19 min), FLAIR (4:00 min) and pre- and postcontrast T1 spin-echo sequences (3:37 min). Brain lesions were counted and categorized according to their anatomic location. Patients were classified according to Barkhof MRI criteria for FLAIR and T2 TSE sequences. The FLAIR sequence detected more lesions in every anatomic region except for the infratentorial region. The higher sensitivity was significant for the total number of lesions (p<0.01), the juxtacortical (p<0.01), and the periventricular (p=0.01) region. A 9% increase of infratentorial lesions using the T2 TSE sequence was not significant. The higher sensitivity using the FLAIR sequence resulted in one additional MRI criterion in nine patients, whereas the better detection of infratentorial lesions using the T2 TSE sequence resulted in additional MRI criteria in three patients. In conclusion, FLAIR provides the highest sensitivity when compared with the T2 TSE, although T2 TSE still has a diagnostic relevance in terms of MRI criteria classification.
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Affiliation(s)
- Mike P Wattjes
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
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Sicotte NL, Voskuhl RR, Bouvier S, Klutch R, Cohen MS, Mazziotta JC. Comparison of multiple sclerosis lesions at 1.5 and 3.0 Tesla. Invest Radiol 2003; 38:423-7. [PMID: 12821856 DOI: 10.1097/01.rli.0000065426.07178.f1] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the relative sensitivity of MR scanning for multiple sclerosis (MS) at 1.5 Tesla (T) and 3.0 T using identical acquisition conditions, as is typical of multicenter clinical trials. METHODS Twenty-five subjects with MS were scanned at 1.5 T and 3.0 T using fast spin echo, and T(1)-weighted SPGR with and without gadolinium contrast injections. Image data, blinded to field strength, were analyzed using automated segmentation and lesion counting. RESULTS Relative to scanning at 1.5 T, the 3.0 T scans showed a 21% increase in the number of detected contrast enhancing lesions, a 30% increase in enhancing lesion volume and a 10% increase in total lesion volume. DISCUSSION The improved detection ability using high-field MR imaging is prominent even when sequence parameters are optimized around the midfield units. Multicenter trials using both 1.5 T and 3.0 T instruments may be affected by these sensitivity differences.
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Affiliation(s)
- Nancy L Sicotte
- Department of Neurology, Division of Brain Mapping, University of California Los Angeles, Los Angeles, CA, USA
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12
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Merl T, Scholz M, Gerhardt P, Langer M, Laubenberger J, Weiss HD, Gehl HB, Wolf KJ, Ohnesorge I. Results of a prospective multicenter study for evaluation of the diagnostic quality of an open whole-body low-field MRI unit. A comparison with high-field MRI measured by the applicable gold standard. Eur J Radiol 1999; 30:43-53. [PMID: 10389012 DOI: 10.1016/s0720-048x(98)00134-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the diagnostic quality of an open whole-body low-field MRI scanner compared to high-field scanners. MATERIALS AND METHODS Over a period of 3 months, 401 patients with diseases of the kidney (n = 78), the shoulder (n = 122), the spine (n = 105) and the cerebrum (n = 96) were prospectively evaluated in four participating centers. They all underwent clinical evaluation, low-field and high-field MRI examination and surgical or follow-up confirmation of diagnosis. Clinical, histopathologic, high-field and low-field MRI diagnoses were recorded in standardized questionnaires that were centrally evaluated. Statistical evaluation comprised two parts: ROC analysis assessed accuracy of MRI and clinical diagnoses; furthermore rates of concordance of high- and low-field MRI diagnosis were calculated. RESULTS We found no statistically relevant difference in high-field MRI diagnosis compared to low-field MRI diagnostic accuracy measured by clinical or surgical gold standard in three of the four regions examined; in cerebral examinations there was a small yet significant advantage for the high-field systems (P = 0.01). CONCLUSION We conclude that the open low-field scanner we evaluated using clinical and surgical gold standard as reference is able to achieve comparable diagnostic accuracy compared to high-field scanners at lower costs and greater patient comfort. Limitations due to field strength (signal-to-noise ratio, resolution, scan time) seem to be relevant only in a very small number of cases that warrant high-field examination.
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Affiliation(s)
- T Merl
- Institute of Diagnostic Radiology, Klinikum rechts der Isar, Technischen Universität München, Germany.
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Passariello R. The present and future of magnetic resonance imaging in an era of cost containment in Europe. Acad Radiol 1998; 5 Suppl 2:S456-7. [PMID: 9750884 DOI: 10.1016/s1076-6332(98)80384-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- R Passariello
- University of Rome La Sapienza, Instituto di RadiologiaCattedra 11-Policlinico Umberto 1, Italy
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Hittmair K, Kramer J, Rand T, Bernert G, Wimberger D. Infratentorial brain maturation: a comparison of MRI at 0.5 and 1.5T. Neuroradiology 1996; 38:360-6. [PMID: 8738096 DOI: 10.1007/bf00596589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Our purpose was to establish parameters for normal infratentorial brain maturation at 0.5 and 1.5 T and to evaluate the field strength criteria for the assessment of infratentorial brain maturation with MRI. We examined 27 children with normal psychomotor development (3 days to 24 months) with a 1.5 T system and 22 (4 days to 29 months) with a 0.5 T system; standard T2-weighted spin-echo sequences (TR/TE 2500/90 ms at 1.5 T and TR/TE 2200/90 ms at 0.5 T) were obtained. The signal intensity of infratentorial anatomical structures compared to their surroundings was classified as high, isointense or low by three neuroradiologists. For anatomical structures with age-related contrast changes, the time of these changes was determined statistically for the 0.5 T and 1.5 T system independently. The delineation of the structures without age-related contrast changes at the two field strengths was compared using a chi 2 test. Age-related contrast changed were found in the same anatomical structures ("marker sites") at 0.5 and 1.5 T. Generally, these changes were apparent in larger structures (pons, middle cerebellar peduncles, medulla, cerebellar folia, red nuclei, cerebral peduncles), with only slight field-strength-dependent differences in the time of the contrast changes. Contrast changes from high to isointense signal were observed slightly earlier at 0.5 T and changes from isointense to low signal slightly later at 0.5 T. The delineation of the smaller anatomical structures was significantly better at 1.5 T but these structures did not show age-related contrast changes. The differences in the assessment of infratentorial brain maturation between 0.5 and 1.5 T can be attributed to a lower signal-to-noise ratio at lower magnetic field strengths. These differences do not complicate temporal classification of the stage of infratentorial brain maturation using the same "marker sites" and the same temporal criteria at 0.5 or 1.5 T. However, higher field strengths are preferable for the assessment of smaller structures with physiological signal differences; this may imply better detection of small lesions at higher field strengths.
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Affiliation(s)
- K Hittmair
- MR Institute, University of Vienna, Austria
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