Detection of Spinal Cord Multiple Sclerosis Lesions Using a 3D-PSIR Sequence at 1.5 T

Sönke Peters; Fernando Bueno Neves; Monika Huhndorf; Friederike Gärtner; Klarissa Stürner; Olav Jansen; Mona Salehi Ravesh

doi:10.1007/s00062-023-01376-x

Detection of Spinal Cord Multiple Sclerosis Lesions Using a 3D-PSIR Sequence at 1.5 T

Clin Neuroradiol. 2024 Jan 30. doi: 10.1007/s00062-023-01376-x. Online ahead of print.

Authors

Sönke Peters¹, Fernando Bueno Neves², Monika Huhndorf², Friederike Gärtner², Klarissa Stürner³, Olav Jansen², Mona Salehi Ravesh²

Affiliations

¹ Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany. Soenke.peters@uksh.de.
² Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
³ Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.

PMID: 38289376
DOI: 10.1007/s00062-023-01376-x

Abstract

Purpose: Multiple sclerosis (MS) is a prevalent autoimmune inflammatory disease. Besides cerebral manifestations, an affection of the spinal cord is typical; however, imaging of the spinal cord is difficult due to its anatomy. The aim of this study was to assess the diagnostic value of a 3D PSIR pulse sequencing at a 1.5 T magnetic field strength for both the cervical and thoracic spinal cord.

Methods: Phase sensitive inversion recovery (PSIR), short tau inversion recovery (STIR) and T₂-weighted (T₂-w) images of the spinal cord of 50 patients were separately evaluated by three radiologists concerning the number and location of MS lesions. Furthermore, lesion to cord contrast ratios were determined for the cervical and thoracic spinal cord.

Results: Of the lesions 54.81% were located in the cervical spinal cord, 42.26% in the thoracic spinal cord and 2.93% in the conus medullaris. The PSIR images showed a higher sensitivity for lesion detection in the cervical and thoracic spinal cord (77.10% and 72.61%, respectively) compared to the STIR images (58.63% and 59.10%, respectively) and the T₂-w images (59.95% and 59.52%, respectively). The average lesion to cord contrast ratio was significantly higher in the PSIR images compared to the STIR images (p < 0.001) and the T₂-w images (p < 0.001).

Conclusion: Evaluation of the spinal cord with a 3D PSIR sequence at a magnetic field strength of 1.5 T is feasible with a high sensitivity for the detection of spinal MS lesions for the cervical as well as the thoracic segments. In combination with other pulse sequences it might become a valuable addition in an advanced imaging protocol.

Keywords: MRI; Multiple sclerosis; STIR; Spinal cord; T2-weighted.