title: Comparison of three MR sequences for the detection of cervical cord lesions in patients with multiple sclerosis.
abstract: OBJECTIVE
  Improving the sensitivity of MR imaging for the detection of multiple sclerosis (MS) lesions in the cord might be useful in the diagnostic workup and could lead to a better understanding of the evolution of the disease. The purpose of this study was to compare fast spin-echo (FSE) with magnetization transfer-prepared gradient-echo (MT-GE) and fast short-inversion-time inversion recovery (fast-STIR) MR sequences to determine which is best for imaging cervical cord lesions in MS patients.
  
  
  METHODS
  FSE, MT-GE, and fast-STIR MR images were obtained in 56 MS patients and 10 healthy control subjects with a 1.5-T MR system and a phased-array coil. Cord lesions seen on images obtained with each sequence were counted by two observers in two stages (stage 1: random review of the complete sets of images from each technique; stage 2: side-by-side review with a retrospective count of lesions).
  
  
  RESULTS
  At the end of stage 1, a mean of 1.16 cord lesions per patient were seen on FSE images, 1.57 on MT-GE images (35% more than on FSE), and 1.92 on fast-STIR images (66% more than on FSE). Two or more cervical cord lesions were found on 16 FSE images (29%), 23 on MT-GE images (46%), and 30 on fast-STIR images (54%). Differences were reduced after stage 2: MT-GE detected 22% more lesions and fast-STIR 36% more lesions than FSE. Considering the three sequences together, 113 cervical cord lesions were seen in 50 patients (89%).
  
  
  CONCLUSIONS
  Both MT-GE and fast-STIR sequences depict more cervical cord MS lesions than the FSE sequence, with fast-STIR having the best sensitivity. Fast-STIR MR images may be useful for the diagnostic workup of patients with suspected MS and for improving our understanding of the evolution of MS.
authors.affiliation: Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Rocca
authors.forename: G
authors.initials: G
authors.lastname: Mastronardo
authors.forename: M A
authors.initials: MA
authors.lastname: Horsfield
authors.forename: C
authors.initials: C
authors.lastname: Pereira
authors.forename: G
authors.initials: G
authors.lastname: Iannucci
authors.forename: B
authors.initials: B
authors.lastname: Colombo
authors.forename: L
authors.initials: L
authors.lastname: Moiola
authors.forename: G
authors.initials: G
authors.lastname: Comi
authors.forename: M
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000328:Adult; D016477:Artifacts; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000473:pathology*