Academic Radiology
Volume 15, Issue 1 , Pages 15-23, January 2008

Diagnostic Value of Contrast-Enhanced Fluid-Attenuated Inversion-Recovery and Delayed Contrast-Enhanced Brain MRI in Multiple Sclerosis

  • Mohammad Hadi Bagheri, MD

      Affiliations

    • Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
    • ,
  • Arash Meshksar, MD

      Affiliations

    • Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
    • Corresponding Author InformationAddress correspondence to: A.M.
    • ,
  • Seyyed Ali Nabavizadeh, MD

      Affiliations

    • Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
    • ,
  • Afshin Borhani-Haghighi, MD

      Affiliations

    • Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.
    • ,
  • Nahid Ashjazadeh, MD

      Affiliations

    • Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.
    • ,
  • Alireza R. Nikseresht, MD

      Affiliations

    • Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.

Received 28 June 2007; accepted 26 July 2007.

Rationale and Objectives

In brain MRI of multiple sclerosis (MS) patients, enhancement of the lesions is usually evaluated in early contrast-enhanced T1-weighted images (CE-T1WI). The objective of this study is to determine the sensitivity of contrast-enhanced fluid-attenuated-inversion-recovery (CE-FLAIR) and delayed contrast-enhanced MRI in evaluation of MS brain lesions.

Materials and Methods

Brain MRI examination including early and delayed CE-T1WI and early and delayed CE-FLAIR images was performed for 46 patients with clinically definite MS disease. Number, size, location, degree, and pattern of enhancement of the enhanced lesions in each sequence were recorded separately.

Results

A total number of 87 enhanced lesions was detected in 30 patients. Early CE-T1WI could detect only 63 lesions (72.4% of total) in 24 patients, while delayed CE-T1WI and early and delayed CE-FLAIR images showed 85 (97.7%), 84 (96.6%), and 81 (93.1%) lesions in 28, 28, and 26 patients, respectively. A greater degree of enhancement and larger lesion size were observed in the additional sequences compared with the early CE-T1WI.

Conclusions

The sensitivity of early CE-T1WI for the detection of enhanced MS lesions is significantly lower than that for other additional sequences. Delayed CE-FLAIR images could not add significant information to other sequences. Therefore, early CE-FLAIR and delayed CE-T1WI brain MRI can be considered as part of the evaluation of MS patients, especially if, despite clinically suspected active disease, no enhanced lesion is found in the routine CE-T1WI.

Key Words: Brain, multiple sclerosis, magnetic resonance imaging, FLAIR, contrast-enhanced

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PII: S1076-6332(07)00450-3

doi:10.1016/j.acra.2007.07.022

Academic Radiology
Volume 15, Issue 1 , Pages 15-23, January 2008

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