1
|
Sastre-Garriga J, Vidal-Jordana A, Toosy AT, Enzinger C, Granziera C, Frederiksen J, Ciccarelli O, Filippi M, Montalban X, Tintore M, Pareto D, Rovira À. Value of Optic Nerve MRI in Multiple Sclerosis Clinical Management: A MAGNIMS Position Paper and Future Perspectives. Neurology 2024; 103:e209677. [PMID: 39018513 DOI: 10.1212/wnl.0000000000209677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024] Open
Abstract
The optic nerve is frequently involved in multiple sclerosis (MS). However, MRI of the optic nerve is considered optional in the differential diagnosis of optic neuropathy symptoms either at presentation or in established MS. In addition, unlike spinal cord imaging in comparable scenarios, no role is currently recommended for optic nerve MRI in patients presenting with optic neuritis for its confirmation, to plan therapeutic strategy, within the MS diagnostic framework, nor for the detection of subclinical activity in established MS. In this article, evidence related to these 3 aspects will be summarized and gaps in knowledge will be highlighted, including (1) the acquisition challenges and novel sequences that assess pathologic changes within the anterior visual pathways; (2) the clinical implications of quantitative magnetic resonance studies of the optic nerve, focusing on atrophy measures, magnetization transfer, and diffusion tensor imaging; and (3) the relevant clinical studies performed to date. Finally, an algorithm for the application of optic nerve MRI will be proposed to guide future studies aimed at addressing our knowledge gaps.
Collapse
Affiliation(s)
- Jaume Sastre-Garriga
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Angela Vidal-Jordana
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Ahmed T Toosy
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Christian Enzinger
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Cristina Granziera
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Jette Frederiksen
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Olga Ciccarelli
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Massimo Filippi
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Xavier Montalban
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Mar Tintore
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Deborah Pareto
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Àlex Rovira
- From the Department of Neurology (J.S.-G., A.V.-J., X.M., M.T.), Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; NMR Research Unit (A.T.T.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, United Kingdom; Department of Neurology and Division of Neuroradiology (C.E.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria; Translational Imaging in Neurology (ThINk) Basel (C.G.), Department of Biomedical Engineering, Faculty of Medicine, University of Basel; Neurology Department and MS Center, University Hospital Basel, Switzerland; Department of Neurology (J.F.), Rigshospitalet-Glostrup, and University of Copenhagen, Glostrup, Denmark; NMR Research Unit (O.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research, United Kingdom; Neuroimaging Research Unit (M.F.), Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy; and Section of Neuroradiology and Magnetic Resonance Unit (D.P., A.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| |
Collapse
|
2
|
Rovira À, Vidal-Jordana A, Auger C, Sastre-Garriga J. Optic Nerve Imaging in Multiple Sclerosis and Related Disorders. Neuroimaging Clin N Am 2024; 34:399-420. [PMID: 38942524 DOI: 10.1016/j.nic.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Optic neuritis is a common feature in multiple sclerosis and in 2 other autoimmune demyelinating disorders such as aquaporin-4 IgG antibody-associated neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease. Although serologic testing is critical for differentiating these different autoimmune-mediated disorders, MR imaging, which is the preferred imaging modality for assessing the optic nerve, can provide valuable information, suggesting a specific diagnosis and guiding the appropriate serologic testing.
Collapse
Affiliation(s)
- Àlex Rovira
- Department of Radiology, Section of Neuroradiology, Vall d'Hebron University Hospital, Autonomous Univesity of Barcelona, Barcelona, Spain.
| | - Angela Vidal-Jordana
- Department of Neurology, Centro de Esclerosis Múltiple de Catalunya (Cemcat), Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Cristina Auger
- Department of Radiology, Section of Neuroradiology, Vall d'Hebron University Hospital, Autonomous Univesity of Barcelona, Barcelona, Spain
| | - Jaume Sastre-Garriga
- Department of Neurology, Centro de Esclerosis Múltiple de Catalunya (Cemcat), Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Riederer SJ, Borisch EA, Froemming AT, Kawashima A, Takahashi N. Comparison of model-based versus deep learning-based image reconstruction for thin-slice T2-weighted spin-echo prostate MRI. Abdom Radiol (NY) 2024:10.1007/s00261-024-04256-1. [PMID: 38520510 DOI: 10.1007/s00261-024-04256-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To compare a previous model-based image reconstruction (MBIR) with a newly developed deep learning (DL)-based image reconstruction for providing improved signal-to-noise ratio (SNR) in high through-plane resolution (1 mm) T2-weighted spin-echo (T2SE) prostate MRI. METHODS Large-area contrast and high-contrast spatial resolution of the reconstruction methods were assessed quantitatively in experimental phantom studies. The methods were next evaluated radiologically in 17 subjects at 3.0 Tesla for whom prostate MRI was clinically indicated. For each subject, the axial T2SE raw data were directed to MBIR and to the DL reconstruction at three vendor-provided levels: (L)ow, (M)edium, and (H)igh. Thin-slice images from the four reconstructions were compared using evaluation criteria related to SNR, sharpness, contrast fidelity, and reviewer preference. Results were compared using the Wilcoxon signed-rank test using Bonferroni correction, and inter-reader comparisons were done using the Cohen and Krippendorf tests. RESULTS Baseline contrast and resolution in phantom studies were equivalent for all four reconstruction pathways as desired. In vivo, all three DL levels (L, M, H) provided improved SNR versus MBIR. For virtually, all other evaluation criteria DL L and M were superior to MBIR. DL L and M were evaluated as superior to DL H in fidelity of contrast. For 44 of the 51 evaluations, the DL M reconstruction was preferred. CONCLUSION The deep learning reconstruction method provides significant SNR improvement in thin-slice (1 mm) T2SE images of the prostate while retaining image contrast. However, if taken to too high a level (DL High), both radiological sharpness and fidelity of contrast diminish.
Collapse
Affiliation(s)
| | - Eric A Borisch
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | | | - Naoki Takahashi
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| |
Collapse
|
4
|
Shor N, Lamirel C, Rebbah S, Vignal C, Vasseur V, Savatovsky J, de la Motte MB, Gout O, Lecler A, Hage R, Deschamps R. High diagnostic accuracy of T2FLAIR at 3 T in the detection of optic nerve head edema in acute optic neuritis. Eur Radiol 2024; 34:1453-1460. [PMID: 37668695 DOI: 10.1007/s00330-023-10139-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Optic nerve head edema (ONHE) detected by fundoscopy is observed in one-third of patients presenting optic neuritis (ON). While ONHE is an important semiological feature, the correlation between ONHE and optic nerve head MRI abnormalities (ONHMA), sometimes called "optic nerve head swelling," remains unknown. Our study aimed to assess the diagnostic accuracy of T2 fluid-attenuated inversion recovery (FLAIR) MRI sequence in detecting ONHE in patients with acute ON. METHODS In the present single-center study, data were extracted from two prospective cohort studies that consecutively included adults with a first episode of acute ON treated between 2015 and 2020. Two experienced readers blinded to study data independently analyzed imaging. A senior neuroradiologist resolved any discrepancies. The primary judgment criterion of ONHMA was assessed as optic nerve head high signal intensity on gadolinium-enhanced T2FLAIR MRI sequence. Its diagnostic accuracy was evaluated with both the gold standard of ONHE on fundus photography (FP) and peripapillary retinal nerve fiber layer thickening on optic coherence tomography (OCT). RESULTS A total of 102 patients were included, providing 110 affected and 94 unaffected optic nerves. Agreement was high between the different modalities: 92% between MRI and FP (k = 0.77, 95% CI: 0.67-0.88) and 93% between MRI and OCT (k = 0.77, 95% CI: 0.67-0.87). MRI sensitivity was 0.84 (95% CI: 0.70-0.93) and specificity was 0.94 (95% CI: 0.89-0.97) when compared with the FP. CONCLUSION Optic nerve head high T2FLAIR signal intensity corresponds indeed to the optic nerve head edema diagnosed by the ophthalmologists. MRI is a sensitive tool for detecting ONHE in patients presenting acute ON. CLINICAL RELEVANCE STATEMENT In patients with optic neuritis the high T2FLAIR (fluid-attenuated inversion recovery) signal intensity of the optic nerve head corresponds indeed to optic nerve head edema, which is a useful feature in optic neuritis etiological evaluation and treatment. KEY POINTS Optic nerve head edema is a prominent clinical feature of acute optic neuritis and is usually diagnosed during dilated or non-dilated eye fundus examination. Agreement was high between magnetic resonance imaging, fundus photography, and optical coherence tomography. Optic nerve head high T2 fluid attenuation inversion recovery signal intensity is a promising detection tool for optic nerve head edema in patients presenting acute optic neuritis.
Collapse
Affiliation(s)
- Natalia Shor
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, Paris, France.
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
- Department of Neuroradiology, C.H.N.O. des Quinze-Vingt, Paris, France.
| | - Cedric Lamirel
- Department of Neuro-ophthalmology, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Sana Rebbah
- Data Analysis Core, Paris Brain Institute (ICM), Sorbonne University, Paris, France
| | - Catherine Vignal
- Department of Neuro-ophthalmology, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Vivien Vasseur
- Clinical Research Department, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Julien Savatovsky
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, Paris, France
| | | | - Olivier Gout
- Department of Neurology, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Augustin Lecler
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Rabih Hage
- Department of Neuro-ophthalmology, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Romain Deschamps
- Department of Neurology, Foundation Adolphe de Rothschild Hospital, Paris, France
| |
Collapse
|
5
|
Panyaping T, Tunlayadechanont P, Jindahra P, Cheecharoen P. Diagnostic value of contrast-enhanced 3D FLAIR sequence in acute optic neuritis. Neuroradiol J 2023; 36:674-679. [PMID: 37205609 PMCID: PMC10649524 DOI: 10.1177/19714009231177360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
PURPOSE Contrast-enhanced fluid-attenuated inversion recovery (FLAIR) sequence of the brain has the potential for detecting optic nerve abnormality. This study aimed to compare the diagnostic value of whole-brain contrast-enhanced three-dimensional FLAIR with fat suppression (CE 3D FLAIR FS) sequence in detecting acute optic neuritis to dedicated orbit MRI and clinical diagnosis. MATERIALS AND METHODS Twenty-two patients with acute optic neuritis who underwent whole-brain CE-3D-FLAIR FS and dedicated orbit MRI were retrospectively included. The hypersignal FLAIR of the optic nerve on whole-brain CE-3D-FLAIR FS, enhancement, and hypersignal T2W on orbit images were assessed. The optic nerve to frontal white matter signal intensity ratio on CE-FLAIR FS was calculated as maximum signal intensity ratio (SIR) and mean SIR. RESULTS Twenty-six hypersignals of optic nerves were found on CE-FLAIR FS from 30 pathologic nerves. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CE FLAIR FS brain and dedicated orbital images for diagnosing acute optic neuritis were 77%, 93%, 96%, 65%, and 82% and 83%, 93%, 96%, 72%, and 86%, respectively. Optic nerve to frontal white matter SIR of the affected optic nerves was higher than that of normal optic nerves. Using a cutoff maximum SIR of 1.24 and cutoff mean SIR of 1.16, the sensitivity, specificity, PPV, NPV, and accuracy were 93%, 86%, 93%, 80%, and 89% and 93%, 86%, 93%, 86%, and 91%, respectively. CONCLUSION The hypersignal of the optic nerve on whole-brain CE 3D FLAIR FS sequence has qualitative and quantitative diagnostic potential in patients with acute optic neuritis.
Collapse
Affiliation(s)
- Theeraphol Panyaping
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Padcha Tunlayadechanont
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Panitha Jindahra
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Piyaphon Cheecharoen
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|
6
|
Borisch EA, Froemming AT, Grimm RC, Kawashima A, Trzasko JD, Riederer SJ. Model-based image reconstruction with wavelet sparsity regularization for through-plane resolution restoration in T 2 -weighted spin-echo prostate MRI. Magn Reson Med 2023; 89:454-468. [PMID: 36093998 PMCID: PMC9617775 DOI: 10.1002/mrm.29447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose is to develop a model-based image-reconstruction method using wavelet sparsity regularization for maintaining restoration of through-plane resolution but with improved retention of SNR versus linear reconstruction using Tikhonov (TK) regularization in high through-plane resolution (1 mm) T2 -weighted spin-echo (T2SE) images of the prostate. METHODS A wavelet sparsity (WS)-regularized image reconstruction was developed that takes as input a set of ≈80 overlapped 3-mm-thick slices acquired using a T2SE multislice scan and typically 30 coil elements. After testing in contrast and resolution phantoms and calibration in 6 subjects, the WS reconstruction was evaluated in 16 consecutive prostate T2SE MRI exams. Results reconstructed with nominal 1-mm thickness were compared with those from the TK reconstruction with the same raw data. Results were evaluated radiologically. The ratio of magnitude of prostate signal to periprostatic muscle signal was used to assess the presence of noise reduction. Technical performance was also compared with a commercial 3D-T2SE sequence. RESULTS The new WS reconstruction was assessed as superior statistically to TK for overall SNR, contrast, and multiple evaluation criteria related to sharpness while retaining the high (1 mm) through-plane resolution. Wavelet sparsity tended to provide improved overall diagnostic quality versus TK, but not significantly so. In all 16 studies, the prostate-to-muscle signal ratio increased. CONCLUSIONS Model-based WS-regularized reconstruction consistently provides improved SNR in high (1 mm) through-plane resolution images of prostate T2SE MRI versus linear reconstruction using TK regularization.
Collapse
|
7
|
Comparison of 3D Double Inversion Recovery (DIR) Versus 3D Fluid Attenuated Inversion Recovery (FLAIR) in Precise Diagnosis of Acute Optic Neuritis. Eur J Radiol 2022; 155:110505. [DOI: 10.1016/j.ejrad.2022.110505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 11/23/2022]
|
8
|
Borisch EA, Grimm RC, Kargar S, Kawashima A, Rossman PJ, Riederer SJ. Cross correlation-based misregistration correction for super resolution T 2 -weighted spin-echo images: application to prostate. Magn Reson Med 2021; 85:1350-1363. [PMID: 32970892 PMCID: PMC7718320 DOI: 10.1002/mrm.28518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/12/2020] [Accepted: 08/23/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose is to develop a retrospective correction for subtle slice-to-slice positional inconsistencies that can occur when overlapped slices are acquired for super resolution in T2 -weighted spin-echo multislice imaging. METHODS Spin-echo acquisition of overlapped slices is typically done using multiple passes. After the passes are assembled into the final slice set, consecutive slices are correlated due to their overlap. Cross correlation was used to measure slice-to-slice displacement. After Z-dependent filtering to preserve true object shape, the displacements were used to correct slice position. The method was tested in a phantom moved slowly (0.16-0.63 mm/pass) under computer control and in vivo in 16 patients having prostate MRI. RESULTS Over the motion range, the correlation method had an accuracy within 0.03 mm/pass and precision ± 0.20 mm (ie, subpixel). Corrected images visually resemble the true object. Over the patient studies, the mean range of motion in the anterior-posterior direction was 1.63 mm. Motion-corrected axial images and the sagittal reformats were evaluated as significantly superior over those formed without motion correction. CONCLUSION The retrospective correlation-based motion-correction method provides significant improvement in the slice-to-slice registration necessary for effective super resolution using overlapped slices.
Collapse
Affiliation(s)
| | | | - Soudabeh Kargar
- Department of Radiology, Mayo Clinic, Rochester MN
- Department of Radiology, University of Wisconsin, Madison WI
| | | | | | | |
Collapse
|
9
|
Outteryck O, Lopes R, Drumez É, Labreuche J, Lannoy J, Hadhoum N, Boucher J, Vermersch P, Zedet M, Pruvo JP, Zéphir H, Leclerc X. Optical coherence tomography for detection of asymptomatic optic nerve lesions in clinically isolated syndrome. Neurology 2020; 95:e733-e744. [DOI: 10.1212/wnl.0000000000009832] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/06/2020] [Indexed: 12/24/2022] Open
Abstract
ObjectiveTo evaluate the ability of intereye retinal thickness difference (IETD) measured by optical coherence tomography (OCT) to detect asymptomatic optic nerve involvement in clinically isolated syndrome (CIS).MethodsWe conducted a cross-sectional study of patients who recently presented a CIS (≤4.5 months). All patients underwent OCT and brain/optic nerve MRI. Optic nerve involvement was defined clinically (episode of optic neuritis [ON] or not) and radiologically (optic nerve hypersignal on 3D double inversion recovery [3D-DIR]). We evaluated the sensitivity and specificity of previously published IETD thresholds and report the observed optimal thresholds for identifying symptomatic optic nerve involvement but also for identifying asymptomatic optic nerve involvement (optic nerve hypersignal without ON history). Primary outcomes were ganglion cell–inner plexiform layer (GC-IPL) and peripapillary retinal nerve fiber layer IETD.ResultsThe study group consisted of 130 patients. In the CIS with ON group, 3D-DIR showed a hypersignal in all 41 symptomatic optic nerves and in 11 asymptomatic optic nerves. In the CIS without ON group, 3D-DIR showed a unilateral optic nerve hypersignal in 22 patients and a bilateral optic nerve hypersignal in 7 patients. For the detection of symptomatic and asymptomatic optic nerve lesion, GC-IPL IETD had better performance. We found an optimal GC-IPL IETD threshold ≥2.83 µm (sensitivity 88.2, specificity 83.3%) for the detection of symptomatic lesions and an optimal GC-IPL IETD ≥1.42 µm (sensitivity 89.3%, specificity 72.6%) for the detection of asymptomatic lesions.ConclusionsDetection of asymptomatic optic nerve lesions in CIS requires lower IETD thresholds than previously reported. GC-IPL IETD represents an alternative biomarker to MRI for the detection of asymptomatic optic nerve lesions.Classification of evidenceThis study provides Class I evidence that OCT accurately identifies asymptomatic optic nerve involvement in patients with CIS.
Collapse
|
10
|
Filippi M, Preziosa P, Banwell BL, Barkhof F, Ciccarelli O, De Stefano N, Geurts JJG, Paul F, Reich DS, Toosy AT, Traboulsee A, Wattjes MP, Yousry TA, Gass A, Lubetzki C, Weinshenker BG, Rocca MA. Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines. Brain 2020; 142:1858-1875. [PMID: 31209474 PMCID: PMC6598631 DOI: 10.1093/brain/awz144] [Citation(s) in RCA: 283] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 12/19/2022] Open
Abstract
MRI has improved the diagnostic work-up of multiple sclerosis, but inappropriate image interpretation and application of MRI diagnostic criteria contribute to misdiagnosis. Some diseases, now recognized as conditions distinct from multiple sclerosis, may satisfy the MRI criteria for multiple sclerosis (e.g. neuromyelitis optica spectrum disorders, Susac syndrome), thus making the diagnosis of multiple sclerosis more challenging, especially if biomarker testing (such as serum anti-AQP4 antibodies) is not informative. Improvements in MRI technology contribute and promise to better define the typical features of multiple sclerosis lesions (e.g. juxtacortical and periventricular location, cortical involvement). Greater understanding of some key aspects of multiple sclerosis pathobiology has allowed the identification of characteristics more specific to multiple sclerosis (e.g. central vein sign, subpial demyelination and lesional rims), which are not included in the current multiple sclerosis diagnostic criteria. In this review, we provide the clinicians and researchers with a practical guide to enhance the proper recognition of multiple sclerosis lesions, including a thorough definition and illustration of typical MRI features, as well as a discussion of red flags suggestive of alternative diagnoses. We also discuss the possible place of emerging qualitative features of lesions which may become important in the near future.
Collapse
Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Brenda L Banwell
- Division of Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Olga Ciccarelli
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, UK.,National Institute for Health Research University College London Hospitals Biomedical Research Center, National Institute for Health Research, London, UK
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Friedemann Paul
- NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel S Reich
- Translational Neuroradiology Section, Division of Neuroimmunology and Neurovirology, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ahmed T Toosy
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, UK
| | - Anthony Traboulsee
- MS/MRI Research Group, Djavad Mowafaghian Centre for Brain Health, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.,Faculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mike P Wattjes
- Department of Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Tarek A Yousry
- Division of Neuroradiology and Neurophysics, UCL Institute of Neurology, London, UK.,Lysholm Department of Neuroradiology, London, UK
| | - Achim Gass
- Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Catherine Lubetzki
- Sorbonne University, AP-HP Pitié-Salpétriére Hospital, Department of Neurology, 75013 Paris, France
| | | | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
11
|
Kargar S, Borisch EA, Froemming AT, Grimm RC, Kawashima A, King BF, Stinson EG, Riederer SJ. Modified acquisition strategy for reduced motion artifact in super resolution T 2 FSE multislice MRI: Application to prostate. Magn Reson Med 2020; 84:2537-2550. [PMID: 32419197 DOI: 10.1002/mrm.28315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/24/2020] [Accepted: 04/19/2020] [Indexed: 11/07/2022]
Abstract
PURPOSE To reduce slice-to-slice motion effects in multislice T 2 -weighted fast-spin-echo ( T 2 FSE) imaging, manifest as "scalloping" in reformats, by modification of the acquisition strategy and to show applicability in prostate MRI. METHODS T 2 FSE images of contiguous or overlapping slices are typically acquired using multiple passes in which each pass is comprised of multiple slices with slice-to-slice gaps. Combination of slices from all passes provides the desired sampling. For enhancement of through-plane resolution with super resolution or for reformatting into other orientations, subtle ≈1 mm motion between passes can cause objectionable "scalloping" artifact. Here we address this by subdivision of each pass into multiple segments. Interleaving of segments from the multiple passes causes all slices to be acquired over substantially the same time, reducing pass-to-pass motion effects. This was implemented in acquiring 78 overlapped T 2 FSE axial slices and studied in phantoms and in 14 prostate MRI patients. Super-resolution axial images and sagittal reformats from the original and new segmented acquisitions were evaluated by 3 uroradiologists. RESULTS For all criteria of sagittal reformats, the segmented acquisition was statistically superior to the original. For all sharpness criteria of axial images, although the trend preferred the original acquisition, the difference was not significant. For artifact in axial images, the segmented acquisition was significantly superior. CONCLUSIONS For prostate MRI the new segmented acquisition significantly reduces the scalloping motion artifact that can be present in reformats due to long time lags between the acquisition of adjacent or overlapped slices while retaining image sharpness in the acquired axial slices.
Collapse
Affiliation(s)
- Soudabeh Kargar
- Biomedical Engineering and Physiology, Mayo Clinic, Rochester, MN, USA
- Radiology, Mayo Clinic, Rochester, MN, USA
- Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | | | | | | | - Stephen J Riederer
- Biomedical Engineering and Physiology, Mayo Clinic, Rochester, MN, USA
- Radiology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
12
|
Spectrally fat-suppressed coronal 2D TSE sequences may be more sensitive than 2D STIR for the detection of hyperintense optic nerve lesions. Eur Radiol 2019; 29:6266-6274. [DOI: 10.1007/s00330-019-06255-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/16/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
|
13
|
Stunkel L, Sharma A, Parsons MS, Salter A, Van Stavern GP. Evaluating the Utility of a Postprocessing Algorithm for MRI Evaluation of Optic Neuritis. AJNR Am J Neuroradiol 2019; 40:1043-1048. [PMID: 31048299 DOI: 10.3174/ajnr.a6057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/31/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging is useful for the detection and/or confirmation of optic neuritis. The objective of this study was to determine whether a postprocessing algorithm selectively increases the contrast-to-noise ratio of abnormal optic nerves in optic neuritis, facilitating this diagnosis on MR imaging. MATERIALS AND METHODS In this retrospective case-control study, coronal FLAIR images and coronal contrast-enhanced T1WI from 44 patients (31 eyes with clinically confirmed optic neuritis and 28 control eyes) underwent processing using a proprietary postprocessing algorithm designed to detect and visually highlight regions of contiguous increases in signal intensity by increasing the signal intensities of regions that exceed a predetermined threshold. For quantitative evaluation of the effect on image processing, the contrast-to-noise ratio of equivalent ROIs and the contrast-to-noise ratio between optic nerves and normal-appearing white matter were measured on baseline and processed images. The effect of image-processing on diagnostic performance was evaluated by masked reviews of baseline and processed images by 6 readers with varying experience levels. RESULTS In abnormal nerves, processing resulted in an increase in the median contrast-to-noise ratio from 17.8 to 85.0 (P < .001) on FLAIR and from 19.4 to 93.7 (P < .001) on contrast-enhanced images. The contrast-to-noise ratio for control optic nerves was not affected by processing (P = 0.13). Image processing had a beneficial effect on radiologists' diagnostic performance, with an improvement in sensitivities for 5/6 readers and relatively unchanged specificities. Interobserver agreement improved following processing. CONCLUSIONS Processing resulted in a selective increase in the contrast-to-noise ratio for diseased nerves and corresponding improvement in the detection of optic neuritis on MR imaging by radiologists.
Collapse
Affiliation(s)
- L Stunkel
- From the Department of Neurology (L.S.)
| | - A Sharma
- Mallinckrodt Institute of Radiology (A. Sharma, M.S.P.)
| | - M S Parsons
- Mallinckrodt Institute of Radiology (A. Sharma, M.S.P.)
| | - A Salter
- Division of Biostatistics (A. Salter)
| | - G P Van Stavern
- Department of Ophthalmology and Visual Sciences (G.P.V.S.), Washington University in St. Louis School of Medicine, St. Louis, Missouri.
| |
Collapse
|
14
|
Golden E, Krivochenitser R, Mathews N, Longhurst C, Chen Y, Yu JPJ, Kennedy TA. Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension. AJNR Am J Neuroradiol 2019; 40:334-339. [PMID: 30679213 DOI: 10.3174/ajnr.a5937] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/23/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE The sensitivity of contrast-enhanced 3D-FLAIR has not been assessed in patients with idiopathic intracranial hypertension. The purpose of this study was to evaluate whether hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR imaging is associated with papilledema in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS A retrospective review was conducted from 2012 to 2015 of patients with clinically diagnosed idiopathic intracranial hypertension and age- and sex-matched controls who had MR imaging with contrast-enhanced 3D-FLAIR. Two neuroradiologists graded each optic nerve/optic nerve head on a scale of 0-3. This grade was then correlated with the Frisén Scale, an ophthalmologic scale used for grading papilledema from 0 (normal) to 5 (severe edema). To estimate the correlation between the MR imaging and Frisén scores, we calculated the Kendall τ coefficient. RESULTS Forty-six patients (3 men, 43 women) with idiopathic intracranial hypertension and 61 controls (5 men, 56 women) with normal findings on MR imaging were included in this study. For both eyes, there was moderate correlation between the 2 scales (right eye: τ = 0.47; 95% CI, 0.31-0.57; left eye: τ = 0.38; 95% CI, 0.24-0.49). Interreader reliability for MR imaging scores showed high interreader reliability (right eye: κ = 0.76; 95% CI, 0.55-0.88; left eye: κ = 0.87; 95% CI, 0.78-0.94). Contrast-enhanced 3D-FLAIR imaging correlates with the Frisén Scale for moderate-to-severe papilledema and less so for mild papilledema. CONCLUSIONS Hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR is sensitive for the detection of papilledema in patients with idiopathic intracranial hypertension, which may be useful when prompt diagnosis is crucial.
Collapse
Affiliation(s)
- E Golden
- From the Departments of Radiology (E.G., J.-P.J.Y., T.A.K.)
| | | | | | - C Longhurst
- Department of Biostatistics and Medical Informatics (C.L.)
| | - Y Chen
- Ophthalmology (R.K., N.M., Y.C.)
| | - J-P J Yu
- From the Departments of Radiology (E.G., J.-P.J.Y., T.A.K.).,Psychiatry (J.-P.J.Y.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,Department of Biomedical Engineering (J.-P.J.Y.), College of Engineering.,Neuroscience Training Program (J.-P.J.Y.), Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, Madison, Wisconsin
| | - T A Kennedy
- From the Departments of Radiology (E.G., J.-P.J.Y., T.A.K.)
| |
Collapse
|
15
|
London F, Zéphir H, Hadhoum N, Lannoy J, Vermersch P, Pruvo JP, Hodel J, Leclerc X, Outteryck O. Optic nerve double inversion recovery hypersignal in patients with clinically isolated syndrome is associated with asymptomatic gadolinium-enhanced lesion. Mult Scler 2018; 25:1888-1895. [DOI: 10.1177/1352458518815797] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Optic nerve involvement is not considered in dissemination in space (DIS) or time (DIT) of multiple sclerosis (MS) lesions. Objectives: To evaluate frequency of optic nerve involvement using three-dimensional (3D)-double inversion recovery (DIR) sequence in clinically isolated syndrome (CIS) and to measure its relationship with DIS and DIT (2010 and 2017 McDonald criteria). Methods: From November 2013 to August 2016, 57 CIS patients underwent 3T-magnetic resonance imaging (3T-MRI) including 3D-DIR sequence and optical coherence tomography (OCT) at 3 months after CIS. We assessed signal abnormalities of the optic nerves on DIR sequence and collected data for DIS and DIT criteria according to 2010 and 2017 McDonald criteria. Results: Among the 57 recruited patients, the presence of ⩾1 DIR hypersignal in optic nerve was observed in 36 (63%; 48 optic nerves) including asymptomatic hypersignal in 22 (38.5%; 25 optic nerves). Optic nerve involvement was significantly associated with DIT ( p = 0.006) and MS according to 2010 criteria ( p = 0.01) but was not significantly associated with presence of DIS criteria according to 2010 and 2017 McDonald criteria. We identified a significant ( p < 0.001) temporal peripapillary retinal nerve fiber layer thinning on eyes with optic nerve involvement versus healthy controls. Conclusions: Optic nerve involvement is very frequent at the earliest clinical stage of MS. It is associated with the presence of asymptomatic gadolinium-enhancement and retinal axonal loss and may reflect the inflammatory disease activity level.
Collapse
Affiliation(s)
- Frédéric London
- Department of Neurology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France
| | - Hélène Zéphir
- Department of Neurology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/LIRIC UMR 995, CHU Lille, University of Lille, Lille, France
| | - Nawal Hadhoum
- Department of Neurology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France
| | - Julien Lannoy
- Department of Neurology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France
| | - Patrick Vermersch
- Department of Neurology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/LIRIC UMR 995, CHU Lille, University of Lille, Lille, France
| | - Jean-Pierre Pruvo
- Department of Neuroradiology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/UMR 1171, CHU Lille, University of Lille, Lille, France
| | - Jérôme Hodel
- Department of Neuroradiology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/UMR 1171, CHU Lille, University of Lille, Lille, France
| | - Xavier Leclerc
- Department of Neuroradiology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/UMR 1171, CHU Lille, University of Lille, Lille, France
| | - Olivier Outteryck
- Department of Neurology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/Department of Neuroradiology, Roger Salengro Hospital, CHU Lille, University of Lille, Lille, France/UMR 1171, CHU Lille, University of Lille, Lille, France
| |
Collapse
|
16
|
Umino M, Maeda M, Ii Y, Tomimoto H, Sakuma H. 3D double inversion recovery MR imaging: Clinical applications and usefulness in a wide spectrum of central nervous system diseases. J Neuroradiol 2018; 46:107-116. [PMID: 30016704 DOI: 10.1016/j.neurad.2018.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/03/2018] [Accepted: 06/23/2018] [Indexed: 12/31/2022]
Abstract
Double inversion recovery (DIR) imaging provides two inversion pulses that attenuate signals from cerebrospinal fluid and normal white matter. This review was undertaken to describe the principle of the DIR sequence, the clinical applications of 3D DIR in various central nervous system diseases and the clinical benefits of the 3D DIR compared with those of other MR sequences. 3D DIR imaging provides better lesion conspicuity and topography than other MR techniques. It is particularly useful for diagnosing the following disease entities: cortical and subcortical abnormalities such as multiple sclerosis, cortical microinfarcts and cortical development anomalies; sulcal abnormalities such as meningitis and subacute/chronic subarachnoid hemorrhage; and optic neuritis caused by multiple sclerosis or neuromyelitis optica.
Collapse
Affiliation(s)
- Maki Umino
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, 514-8507 Tsu, Mie, Japan.
| | - Masayuki Maeda
- Department of Advanced Diagnostic Imaging, Mie University School of Medicine, Tsu, Mie, Japan
| | - Yuichiro Ii
- Department of Neurology, Mie University School of Medicine, Tsu, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University School of Medicine, Tsu, Mie, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, 514-8507 Tsu, Mie, Japan
| |
Collapse
|
17
|
Toledano-Massiah S, Sayadi A, de Boer R, Gelderblom J, Mahdjoub R, Gerber S, Zuber M, Zins M, Hodel J. Accuracy of the Compressed Sensing Accelerated 3D-FLAIR Sequence for the Detection of MS Plaques at 3T. AJNR Am J Neuroradiol 2018; 39:454-458. [PMID: 29348137 DOI: 10.3174/ajnr.a5517] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 11/03/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE The use of 3D FLAIR improves the detection of brain lesions in MS patients, but requires long acquisition times. Compressed sensing reduces acquisition time by using the sparsity of MR images to randomly undersample the k-space. Our aim was to compare the image quality and diagnostic performance of 3D-FLAIR with and without compressed sensing for the detection of multiple sclerosis lesions at 3T. MATERIALS AND METHODS Twenty-three patients with relapsing-remitting MS underwent both conventional 3D-FLAIR and compressed sensing 3D-FLAIR on a 3T scanner (reduction in scan time 1 minute 25 seconds, 27%; compressed sensing factor of 1.3). Two blinded readers independently evaluated both conventional and compressed sensing FLAIR for image quality (SNR and contrast-to-noise ratio) and the number of MS lesions visible in the periventricular, intra-juxtacortical, infratentorial, and optic nerve regions. The volume of white matter lesions was measured with automatic postprocessing segmentation software for each FLAIR sequence. RESULTS Image quality and the number of MS lesions detected by the readers were similar between the 2 FLAIR acquisitions (P = .74 and P = .094, respectively). Almost perfect agreement was found between both FLAIR acquisitions for total MS lesion count (Lin concordance correlation coefficient = 0.99). Agreement between conventional and compressed sensing FLAIR was almost perfect for periventricular and infratentorial lesions and substantial for intrajuxtacortical and optic nerve lesions. Postprocessing with the segmentation software did not reveal a significant difference between conventional and compressed sensing FLAIR in total MS lesion volume (P = .63) or the number of MS lesions (P = .15). CONCLUSIONS With a compressed sensing factor of 1.3, 3D-FLAIR is 27% faster and preserves diagnostic performance for the detection of MS plaques at 3T.
Collapse
Affiliation(s)
| | - A Sayadi
- From the Departments of Radiology (S.T.-M., A.S., S.G., M.Zins)
| | - R de Boer
- Quantib B.V. (R.d.B., J.G.), Rotterdam, the Netherlands
| | - J Gelderblom
- Quantib B.V. (R.d.B., J.G.), Rotterdam, the Netherlands
| | | | - S Gerber
- From the Departments of Radiology (S.T.-M., A.S., S.G., M.Zins)
| | - M Zuber
- Neurology (M.Zuber), Fondation Hôpital Saint-Joseph, Paris, France
| | - M Zins
- From the Departments of Radiology (S.T.-M., A.S., S.G., M.Zins)
| | - J Hodel
- Department of Neuroradiology (J.H.), AP-HP, Hôpitaux Universitaires Henri Mondor, Université Paris est, Créteil, France
| |
Collapse
|
18
|
High-Resolution Isotropic Three-Dimensional MR Imaging of the Extraforaminal Segments of the Cranial Nerves. Magn Reson Imaging Clin N Am 2018; 26:101-119. [DOI: 10.1016/j.mric.2017.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
19
|
Abstract
Orbital lesions form a wide range of pathologies, that create challenges in diagnosis, management, and treatment. The high-resolution soft tissue detail provided by magnetic resonance imaging (MRI) has allowed for better lesion characterization. Especially in cases where history and clinical evaluation are insufficient, MRI plays a crucial role. MRI is also important in the detection of the extent of orbital diseases. The aim of this study was to examine the MRI characteristics of common and/or rare diseases arising from or extending into the orbita to aid radiologists in the correct diagnosis of orbital lesions.
Collapse
|
20
|
Sartoretti T, Sartoretti E, Rauch S, Binkert C, Wyss M, Czell D, Sartoretti-Schefer S. How Common Is Signal-Intensity Increase in Optic Nerve Segments on 3D Double Inversion Recovery Sequences in Visually Asymptomatic Patients with Multiple Sclerosis? AJNR Am J Neuroradiol 2017; 38:1748-1753. [PMID: 28663263 DOI: 10.3174/ajnr.a5262] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/12/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In postmortem studies, subclinical optic nerve demyelination is very common in patients with MS but radiologic demonstration is difficult and mainly based on STIR T2WI. Our aim was to evaluate 3D double inversion recovery MR imaging for the detection of subclinical demyelinating lesions within optic nerve segments. MATERIALS AND METHODS The signal intensities in 4 different optic nerve segments (ie, retrobulbar, canalicular, prechiasmatic, and chiasm) were evaluated on 3D double inversion recovery MR imaging in 95 patients with MS without visual symptoms within the past 3 years and in 50 patients without optic nerve pathology. We compared the signal intensities with those of the adjacent lateral rectus muscle. The evaluation was performed by a student group and an expert neuroradiologist. Statistical evaluation (the Cohen κ test) was performed. RESULTS On the 3D double inversion recovery sequence, optic nerve segments in the comparison group were all hypointense, and an isointense nerve sheath surrounded the retrobulbar nerve segment. At least 1 optic nerve segment was isointense or hyperintense in 68 patients (72%) in the group with MS on the basis of the results of the expert neuroradiologist. Student raters were able to correctly identify optic nerve hypersignal in 97%. CONCLUSIONS A hypersignal in at least 1 optic nerve segment on the 3D double inversion recovery sequence compared with hyposignal in optic nerve segments in the comparison group was very common in visually asymptomatic patients with MS. The signal-intensity rating of optic nerve segments could also be performed by inexperienced student readers.
Collapse
Affiliation(s)
- T Sartoretti
- From the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
| | - E Sartoretti
- From the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
| | - S Rauch
- From the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
| | - C Binkert
- From the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
| | - M Wyss
- From the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
| | - D Czell
- Klinik für Innere Medizin (D.C.), Abteilung für Neurologie, Kantonsspital Winterthur, Winterthur, Switzerland
| | | |
Collapse
|
21
|
Boegel KH, Tyan AE, Iyer VR, Rykken JB, McKinney AM. Utility of coronal contrast-enhanced fat-suppressed FLAIR in the evaluation of optic neuropathy and atrophy. Eur J Radiol Open 2017; 4:13-18. [PMID: 28275657 PMCID: PMC5331143 DOI: 10.1016/j.ejro.2017.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/18/2017] [Accepted: 02/20/2017] [Indexed: 11/19/2022] Open
Abstract
Background and purpose Evaluating chronic sequelae of optic neuritis, such as optic neuropathy with or without optic nerve atrophy, can be challenging on whole brain MRI. This study evaluated the utility of dedicated coronal contrast-enhanced fat-suppressed FLAIR (CE-FS-FLAIR) MR imaging to detect optic neuropathy and optic nerve atrophy. Materials and methods Over 4.5 years, a 3 mm coronal CE-FS-FLAIR sequence at 1.5T was added to the routine brain MRIs of 124 consecutive patients, 102 of whom had suspected or known demyelinating disease. Retrospective record reviews confirmed that 28 of these 102 had documented onset of optic neuritis >4 weeks prior to the brain MRI. These 28 were compared to the other 22 (“controls”) of the 124 patients who lacked a history of demyelinating disease or visual symptoms. Using coronal CE-FS-FLAIR, two neuroradiologists separately graded each optic nerve (n = 50 patients, 100 total nerves) as either negative, equivocal, or positive for optic neuropathy or atrophy. The scoring was later repeated. Results The mean time from acute optic neuritis onset to MRI was 4.1 ± 4.6 years (range 34 days-17.4 years). Per individual nerve grading, the range of sensitivity, specificity, and accuracy of coronal CE-FS-FLAIR in detecting optic neuropathy was 71.4–77.1%, 93.8–95.4%, and 85.5–89.0%, respectively, with strong interobserver (k = 0.667 − 0.678, p < 0.0001), and intraobserver (k = 0.706 − 0.763, p < 0.0001) agreement. For optic atrophy, interobserver agreement was moderate (k = 0.437 − 0.484, p < 0.0001), while intraobserver agreement was moderate-strong (k = 0.491 − 0.596, p < 0.0001). Conclusion Coronal CE-FS-FLAIR is quite specific in detecting optic neuropathy years after the onset of acute optic neuritis, but is less useful in detecting optic nerve atrophy.
Collapse
|
22
|
Bansal NK, Hagiwara M, Borja MJ, Babb J, Patel SH. Influence of clinical history on MRI interpretation of optic neuropathy. Heliyon 2016; 2:e00162. [PMID: 27699283 PMCID: PMC5035347 DOI: 10.1016/j.heliyon.2016.e00162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/15/2016] [Accepted: 09/12/2016] [Indexed: 11/29/2022] Open
Abstract
Background and purpose Clinical history is known to influence interpretation of a wide range of radiologic examinations. We sought to evaluate the influence of the clinical history on MRI interpretation of optic neuropathy. Materials and methods 107 consecutive orbital MRI scans were retrospectively reviewed by three neuroradiologists. The readers independently evaluated the coronal STIR sequence for optic nerve hyperintensity and/or atrophy (yes/no) and the coronal post-contrast T1WI for optic nerve enhancement (yes/no). Readers initially evaluated the cases blinded to the clinical history. Following a two week washout period, readers again evaluated the cases with the clinical history provided. Inter-reader and reader-clinical radiologist agreement was assessed using Cohen's simple kappa coefficient. Results Intra-reader agreement, without and with provision of clinical history, was 0.564–0.716 on STIR and 0.270–0.495 on post-contrast T1WI. Inter-reader agreement was overall fair-moderate. On post-contrast T1WI, inter-reader agreement was significantly higher when the clinical history was provided (p = 0.001). Reader-clinical radiologist agreement improved with provision of the clinical history to the readers on both the STIR and post-contrast T1WI sequences. Conclusions In the MRI assessment of optic neuropathy, only modest levels of inter-reader agreement were achieved, even after provision of clinical history. Provision of clinical history improved inter-reader agreement, especially when assessing for optic nerve enhancement. These findings confirm the subjective nature of orbital MRI interpretation in cases of optic neuropathy, and point to the importance of an accurate clinical history. Of note, the accuracy of orbital MRI in the context of optic neuropathy was not assessed, and would require further investigation.
Collapse
|
23
|
Visual impairment. HANDBOOK OF CLINICAL NEUROLOGY 2016. [PMID: 27430448 DOI: 10.1016/b978-0-444-53486-6.00045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
This chapter can guide the use of imaging in the evaluation of common visual syndromes: transient visual disturbance, including migraine and amaurosis fugax; acute optic neuropathy complicating multiple sclerosis, neuromyelitis optica spectrum disorder, Leber hereditary optic neuropathy, and Susac syndrome; papilledema and pseudotumor cerebri syndrome; cerebral disturbances of vision, including posterior cerebral arterial occlusion, posterior reversible encephalopathy, hemianopia after anterior temporal lobe resection, posterior cortical atrophy, and conversion blindness. Finally, practical efforts in visual rehabilitation by sensory substitution for blind patients can improve their lives and disclose new information about the brain.
Collapse
|
24
|
Yamada H, Yamamoto A, Okada T, Kanagaki M, Fushimi Y, Porter DA, Tanji M, Hojo M, Miyamoto S, Togashi K. Diffusion tensor imaging of the optic chiasm in patients with intra- or parasellar tumor using readout-segmented echo-planar. Magn Reson Imaging 2016; 34:654-61. [PMID: 26806681 DOI: 10.1016/j.mri.2016.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the impact of surgery on the optic pathway of patients with intra- or parasellar mass lesions, as evidenced by readout-segmented DTI. MATERIALS AND METHODS Twenty-four patients with intra- or parasellar mass lesions were included in the study. Readout-segmented DTI and T2WI were obtained before and after surgery. The ROIs were set on the optic chiasm as well as the anterior and posterior optic tracts. For each ROI, axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), and ADC values were calculated. DTI parameters in preoperative studies of all patients were compared and related to the presence of tumor compression. In patients who underwent surgery, pre- and postoperative DTI parameters were compared. The correlation between DTI parameters and visual function was determined. RESULTS In the preoperative studies, the optic chiasm of patients with tumor compression showed significant lower AD and RD values. The optic chiasm of patients with visual field disorder showed significantly lower AD and RD values compared to patients without the disorder. There was a negative correlation with a trend toward significance between FA values and visual field disorder scores. The comparative analysis of patients in pre- and postoperative studies showed that the optic chiasm of patients with tumor compression presented a significant lower FA (0.41 versus 0.30, p=0.0068) and higher RD values after surgery. CONCLUSIONS DTI is a useful tool to assess the impact of surgery on the optic chiasm and nerve.
Collapse
Affiliation(s)
- Hirofumi Yamada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - David A Porter
- Fraunhofer MEVIS, Universitätsallee 29, 28359, Bremen, Germany
| | - Masahiro Tanji
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masato Hojo
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| |
Collapse
|
25
|
Abstract
Acute visual symptom emergencies occur commonly and present a challenge to both clinical and radiologic facets. Although most patients with visual complaints routinely require clinical evaluation with direct ophthalmologic evaluation, imaging is rarely necessary. However, there are highly morbid conditions where the prompt recognition and management of an acute visual syndrome (AVS) requires an astute physician to probe further. Suspicious symptomatology including abrupt visual loss, diplopia, ophthalmoplegia, and proptosis/exophthalmos require further investigation with advanced imaging modalities such as magnetic resonance imaging and magnetic resonance angiography. This review will discuss a variety of AVSs including orbital apex syndrome, cavernous sinus thrombosis, cavernous carotid fistula, acute hypertensive encephalopathy (posterior reversible encephalopathy syndrome), optic neuritis, pituitary apoplexy including hemorrhage into an existing adenoma, and idiopathic intracranial hypertension. A discussion of each entity will focus on the clinical presentation, management and prognosis when necessary and finally, neuroimaging with emphasis on magnetic resonance imaging. The primary purpose of this review is to provide an organized approach to the differential diagnosis and typical imaging patterns for AVSs. We have provided a template for radiologists and specialists to assist in early intervention in order to decrease morbidity and provide value-based patient care through imaging.
Collapse
Affiliation(s)
- Shalini V Mukhi
- Michael E. DeBakey VA Medical Center Houston and Baylor College of Medicine, Houston, TX
| | | |
Collapse
|
26
|
Hadhoum N, Hodel J, Defoort-Dhellemmes S, Duhamel A, Drumez E, Zéphir H, Pruvo JP, Leclerc X, Vermersch P, Outteryck O. Length of optic nerve double inversion recovery hypersignal is associated with retinal axonal loss. Mult Scler 2015; 22:649-58. [PMID: 26227005 DOI: 10.1177/1352458515598021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 07/07/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To assess the association between optic nerve double inversion recovery (DIR) hypersignal length and retinal axonal loss in neuroinflammatory diseases affecting optic nerves. METHODS We recruited patients previously affected (> 6 months) by a clinical episode of optic neuritis (ON). We had 25 multiple sclerosis (MS) patients, eight neuromyelitis optica spectrum disorder (NMOSD) patients and two patients suffering from idiopathic caused ON undergo brain magnetic resonance imaging (MRI); including a 3-dimensional (3D) DIR sequence, optical coherence tomography (OCT) examination and visual disability evaluation. Evaluation criteria were retinal thickness/volume, optic nerve DIR hypersignal length and high/low contrast vision acuity. RESULTS In the whole cohort, we found good associations (< 0.0001) between optic nerve DIR hypersignal length, peripapillary retinal nerve fiber layer thickness, inner macular layers volumes, and visual disability. We found subclinical radiological optic nerve involvement in 38.5% of non-ON MS eyes. CONCLUSIONS Optic nerve DIR hypersignal length may be a biomarker for retinal axonal loss, easily applicable in routine and research on new anti-inflammatory or neuroprotective drug evaluation. Detection of subclinical ON with 3D-DIR in a non-negligible proportion of MS patients argues in favor of optic nerve imaging in future OCT MS studies, in order to achieve a better understanding of retinal axonal loss in non-ON eyes.
Collapse
Affiliation(s)
- N Hadhoum
- Roger Salengro Hospital, University of Lille, Lille, France
| | - J Hodel
- Roger Salengro Hospital, University of Lille, Lille, France
| | | | - A Duhamel
- Department of Biostatistics, Centre d'Etudes et de Recherche en Informatique Médicale, Lille, France
| | - E Drumez
- Department of Biostatistics, Centre d'Etudes et de Recherche en Informatique Médicale, Lille, France
| | - H Zéphir
- Roger Salengro Hospital, University of Lille, Lille, France
| | - J P Pruvo
- Roger Salengro Hospital, University of Lille, Lille, France
| | - X Leclerc
- Roger Salengro Hospital, University of Lille, Lille, France
| | - P Vermersch
- Roger Salengro Hospital, University of Lille, Lille, France
| | - O Outteryck
- Roger Salengro Hospital, University of Lille, Lille, France
| |
Collapse
|
27
|
Comparison of 3D double inversion recovery and 2D STIR FLAIR MR sequences for the imaging of optic neuritis: pilot study. Eur Radiol 2014; 24:3069-75. [DOI: 10.1007/s00330-014-3342-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 07/03/2014] [Accepted: 07/11/2014] [Indexed: 10/24/2022]
|
28
|
Mugler JP. Optimized three‐dimensional fast‐spin‐echo MRI. J Magn Reson Imaging 2014; 39:745-67. [PMID: 24399498 DOI: 10.1002/jmri.24542] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- John P. Mugler
- Department of Radiology and Medical ImagingUniversity of Virginia School of MedicineCharlottesville Virginia USA
| |
Collapse
|
29
|
McKinney AM, Lohman BD, Sarikaya B, Benson M, Lee MS, Benson MT. Accuracy of routine fat-suppressed FLAIR and diffusion-weighted images in detecting clinically evident acute optic neuritis. Acta Radiol 2013. [DOI: 10.1177/0284185112471797] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Contrast-enhanced, fat-suppressed T1-weighted imaging (CET1WI) magnetic resonance imaging (MRI) is quite sensitive in detecting acute optic neuritis (ON), but ON remains a clinical diagnosis. MRI is indicated to evaluate demyelinating brain lesions rather than the optic nerves, while “routine” brain protocols typically include axial FLAIR and DWI. Purpose To evaluate the accuracy of axial, fat-suppressed FLAIR and DWI sequences used for our routine brain imaging in detecting acute ON, as compared to CET1WI and the clinical diagnosis. Material and Methods The clinical data and MRI examinations were retrospectively reviewed of 60 patients presenting to a neuro-ophthalmologist for various visual symptoms. Each patient underwent dedicated neuro-ophthalmologic examination, with axial 5 mm fat-suppressed FLAIR and DWI (part of “routine” brain MRI protocol), as well as 3 mm axial and coronal fat-suppressed CET1WI (part of dedicated orbit MRI protocol). Two neuroradiologists independently evaluated FLAIR and DWI, while CET1WI was reviewed by consensus. Results Thirty-one patients were clinically positive, 29 negative for ON (total = 34 positive and 86 negative nerves). The sensitivities of FLAIR, DWI, and CET1WI for ON were 75.7–77.3%, 77.3%, and 89.5%, respectively; the specificities were 90.5–93.5%, 80.4–82.7%, and 86.0%, respectively; the accuracies were 85.7–88.2%, 79.5–81.1%, and 87.0%, respectively. Inter-observer kappa was 0.783 for FLAIR, and 0.605 for DWI; intra-observer kappa was 0.746–0.816 for FLAIR, and 0.674–0.699 for DWI (each P < 0.0001). Conclusion Being more specific, but not as sensitive, as dedicated CET1WI in acute ON, axial fat-suppressed FLAIR likely has additional value in evaluating for acute ON in “routine” brain MR protocols evaluating for demyelinating disease, while DWI may be hampered by artifacts.
Collapse
Affiliation(s)
| | | | | | | | - Michael S Lee
- Department Ophthalmology, University of Minnesota Medical Center, Minneapolis, MN, USA
| | | |
Collapse
|
30
|
Denoiseux CC, Boulay-Coletta I, Nakache JP, Claude ID, Zins M. Liver T2-weighted MR imaging: assessment of a three-dimensional fast spin-echo with extended echo train acquisition sequence at 1.5 Tesla. J Magn Reson Imaging 2012; 38:336-43. [PMID: 23239080 DOI: 10.1002/jmri.23975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 10/31/2012] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To retrospectively compare image quality and lesion detectability with two T2-weighted sequences at 1.5 Tesla (T): respiratory-triggered three-dimensional fat sat fast-spin-echo with extended echo-train acquisition (3D FSE-XETA) and respiratory-triggered two-dimensional fat-sat fast recovery fast-spin-echo (2D FRFSE). MATERIALS AND METHODS MR was performed at 1.5T in 53 consecutive patients. Two radiologists blinded to the sequence details reviewed the studies to determine: (i) signal and contrast to noise ratios, (ii) overall image quality, (iii) sensitivity for focal lesion detection. RESULTS Image assessment scores for the 2D FRFSE sequence were significantly higher than those for the 3D FSE-XETA sequence for overall image quality (P < 0.01) and artifacts (P < 0.001). Sensitivity for liver lesion detection was higher with the 3D FSE-XETA sequence (69.3% versus 57.3%; P < 0.05) compared with the 2D FRFSE sequence. The 3D FSE-XETA sequence improves the reader confidence score (P < 0.01) for liver lesions detection. Inter-observer correlation was higher with the 3D FSE-XETA sequence. CONCLUSION For T2-weighted liver imaging at 1.5T, the 3D FSE-XETA sequence improves sensitivity, reader confidence score and interobserver correlation for focal liver lesion detection, but it suffers from a lower overall image quality and higher artifacts.
Collapse
|
31
|
Abstract
Multiple sclerosis (MS) is a disease marked by focal demyelinating inflammatory plaques throughout the CNS. Neuro-ophthalmologic sequelae are common in MS and may arise from the disease itself or from treatment of the disease. Both afferent and efferent functions may be affected. Despite much progress, our understanding of the pathophysiology of MS, and the efficacy of our available treatments, remain inadequate. Here, we review the chief neuro-ophthalmologic abnormalities associated with MS and discuss the emerging diagnostic and therapeutic advances that are likely to further our understanding of MS and its treatment.
Collapse
Affiliation(s)
- Ryan D Walsh
- Departments of Neurology & Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, Philadelphia, PA 19104, USA
| | - Collin M McClelland
- Departments of Neurology & Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, Philadelphia, PA 19104, USA
| | - Steven L Galetta
- Departments of Neurology & Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, 3 W Gates Building, Philadelphia, PA 19104, USA
| |
Collapse
|
32
|
Kralik SF, Kersten R, Glastonbury CM. Evaluation of orbital disorders and cranial nerve innervation of the extraocular muscles. Magn Reson Imaging Clin N Am 2012; 20:413-34. [PMID: 22877949 DOI: 10.1016/j.mric.2012.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A wide range of orbital disorders, including an orbital mass, infection, inflammation, systemic disease, or intracranial lesions, may be encountered with imaging. Evaluation of orbital disorders requires the combination of accurate and relevant clinical information with an understanding of anatomy and pathologic processes. An imaging approach to an orbital differential diagnosis includes assessment for alteration of a normal orbital structure, a lesion that does not belong in the orbit, or alteration of the orbit from bone or periorbital disorders. This approach, combined with key elements of clinical history, leads to a narrower differential diagnosis and improved patient care.
Collapse
Affiliation(s)
- Stephen F Kralik
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 702 Barnhill Drive, Room 1053, Indianapolis, IN 46202, USA.
| | | | | |
Collapse
|