Article Figures & Data
Figures
- Fig 1.
DIR (A), PSIR (B), and FLAIR (C) images from a single patient with MS at the same section location. An intracortical lesion is evident in the left parietal area. Also note the excellent overall delineation of the gray-white matter border on PSIR.
- Fig 2.
Examples of cortical lesions on PSIR (left), DIR (center), and FLAIR (right). Lesions shown are (A) purely intracortical, (B) mixed, and (C) juxtacortical.
- Fig 3.
Example of flow artifact. On the DIR image (A), apparent cortical lesions (arrows) are visible. However, on the PSIR image (B), there are no corresponding hypointense signals. On PSIR, a flow artifact is seen more clearly (arrows), which is the likely source of the false-positive.
- Fig 4.
Example of RF inhomogeneity artifact. On the DIR image (A), an apparent cortical lesion is visible (white arrow). On the PSIR image (B), there is again no corresponding hypointensity. On DIR, the signal intensity is 38% higher for the apparent lesion than the contralateral area, compared with 14% for PSIR. The relative insensitivity of PSIR to the RF artifact allows rejection of the lesion on DIR as a false-positive.
Tables
Age/Sex Disease Type Disease Duration (years) EDSS Score 44/M RR 6 2 50/M SP 10 3 59/F RR 11 2 50/F RR 1.5 0 55/F RR 26 2 53/F RR 12 3 49/F RR 25 5 25/F RR 5 1 64/F SP 29 6.5 62/F SP 45 6.5 24/F RR 5 3 27/F RR 1.5 0 48/F RR 22 1 35/F RR 1.2 2 68/M PP 24 4 39/F RR 11 2 Note:—RR indicates relapsing-remitting; SP, secondary-progressive; PP, primary-progressive; EDSS, Expanded Disability Status Scale.
Sequence Plane TR (ms) TE (ms) TI (ms) Image Matrix FOV (mm) Section (mm) Scan Time (min) PSIR Axial 4300 13 400 256 × 256 240 3 4.0 DIR Axial 15,000 25 3400/325 512 × 512 240 3 6.5 Dual-FSE Axial 6800 10/90 – 256 × 256 240 3 6.0 FLAIR Axial 10,000 80 2600 256 × 256 240 3 3.0 Note:—MS indicates multiple sclerosis; PSIR, phase-sensitive inversion recovery; DIR, double inversion recovery; FSE, fast spin-echo; FLAIR, fluid-attenuated inversion recovery; FOV, field of view.
Type of Lesion PSIR+DIR FLAIR % Improvement P Value Intracortical 7.8 ± 9.4 1.4 ± 1.8 439 .0002 Mixed 9 ± 11 1.8 ± 2.4 414 <.0001 Juxtacortical 2.5 ± 2.4 1.1 ± 1.5 117 .0078 Overall 19.2 ± 21.1 4.3 ± 4.3 345 <.0001 Note:—PSIR indicates phase-sensitive inversion recovery; DIR, double inversion recovery; FLAIR, fluid-attenuated inversion recovery.
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