Clinical Edge

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Detection of Chronic Active MS Lesions on 3T MRI

AJNR Am J Neuroradiol; 2018 Jul; Absinta, et al

For patients with multiple sclerosis (MS), imaging at 3T opens the possibility of implementing paramagnetic rims as an outcome measure in multicenter, MR imaging-based clinical trials aimed at treating perilesional persistent inflammation and its potential effects on remyelination. This according to a recent study where researchers assessed the reliability of detecting these rims on high-resolution 3T phase images. High-resolution T2 and phase MR imaging was collected in 20 patients with MS at 3T (3D segmented EPI, 0.65 mm3) and 7T (2D gradient-echo, 0.2 × 0.2 × 1 mm) MR imaging. In each case, 5 discrete chronic (non-enhancing) MS lesions were selected on T2 FLAIR images for rim evaluation. They found:

  • Nearly all 7T paramagnetic rims can also be seen at 3T.
  • Phase rims were seen in 34 lesions at 7T and in 36 lesions at 3T by consensus.
  • Inter- and intrarater reliability were “substantial/good” both at 3T and 7T analysis.
  • Based on consensus agreement, the reliability of rim visualization at 3T vs 7T was 0.78 (к) with a pair-wise agreement of 90%.
  • More lesions were judged to be false-positive or false-negative at 3T than at 7T.

Citation:

Absinta A, Sati P, Fechner A, Schindler MK, Nair G, Reich DS. Identification of chronic active multiple sclerosis lesions on 3T MRI. AJNR Am J Neuroradiol. 2018;39(7):1233-1238. doi:10.3174/ajnr.A5660.

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