Sensitive Detection of Infratentorial and Upper Cervical Cord Lesions in Multiple Sclerosis with Combined 3D FLAIR and T2-Weighted (FLAIR3) Imaging

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
FIG 1.
Acquired T2-weighted (left) and FLAIR (right) images and the reconstructed FLAIR3 images (middle) from 2 patients with MS (rows). Note the improved contrast of the infratentorial lesions (arrows) on FLAIR3.
Download figure
Open in new tab
Download powerpoint
FIG 2.
Three-plane view showing the improved contrast of infratentorial lesions (red and yellow arrows) on FLAIR3 compared with FLAIR.
Download figure
Open in new tab
Download powerpoint
FIG 3.
Sagittal (upper row) and axial (lower row) sections showing improved contrast of cervical cord lesions on FLAIR3 compared with FLAIR in 3 patients with MS. The lesions were detected on both FLAIR and FLAIR3 in case A, but only on FLAIR3 in cases in B and C.
Download figure
Open in new tab
Download powerpoint
FIG 4.
Scatterplot and linear regression with the 95% confidence interval (shaded) between the raters for the average total number of lesions for 3D T2-FLAIR (upper row, A–C) and FLAIR3 (lower row, D–F).

Table 1:

Characteristics of the study participants

Characteristics
No. of subjects	30
Female/male	24:6
Age (mean) (yr)	43 ± 12
Phenotype
Relapsing-remitting MS	25
Secondary-progressive MS	5
Disease duration (median) (range) (yr)	6.5 (0.3–43.9)
EDSS (median) (range)	1.75 (0–6.5)

Table 2:

Number of lesions per subject detected on 3D T2-FLAIR and FLAIR3

	No. of Lesions per Subject (Mean)
	Rater 1		Rater 2		Rater 3
	T2-FLAIR	FLAIR3	T2-FLAIR	FLAIR3	T2-FLAIR	FLAIR3
All lesions	2.3 ± 2.2	6.9 ± 4.7^{^a}	2.5 ± 2.2	5.5 ± 3.6^{^a}	2.7 ± 2.5	6.1 ± 5.1^{^b}
Infratentorial lesions	2.0 ± 1.9	5.4 ± 4.1^{^a}	2.0 ± 2.0	3.9 ± 3.3^{^c}	2.1 ± 2.4	4.5 ± 4.4^{^c}
Cervical cord lesions	0.27 ± 0.58	1.57 ± 1.14^{^a}	0.50 ± 0.68	1.60 ± 0.81^{^a}	0.60 ± 0.72	1.57 ± 1.17^{^a}

Table 3:

CNR of lesions detected on 3D T2-FLAIR and FLAIR3^a

Table 4:

Number of lesions detected on 3D T2-FLAIR and/or FLAIR3 images

	Rater 1			Rater 2			Rater 3
	FLAIR and FLAIR3	FLAIR Only	FLAIR3 Only	FLAIR and FLAIR3	FLAIR Only	FLAIR3 Only	FLAIR and FLAIR3	FLAIR Only	FLAIR3 Only
No. of lesions
Infratentorial	46	15	115	45	4	72	49	16	89
Cervical cord	7	1	40	13	2	35	14	4	35
No. of subjects with MS with ≥1 lesion
Infratentorial	19	1	9	19	1	7	19	0	6
Cervical cord	6	0	20	13	0	16	14	1	14