The diagnostic utility of FLAIR imaging in clinically verified amyotrophic lateral sclerosis.
OBJECTIVE
To explore the overall diagnostic ability of magnetic resonance (MR) fluid-attenuated inversion recovery (FLAIR) imaging for clinically verified amyotrophic lateral sclerosis (ALS).


METHODS
Abnormal signal intensity in FLAIR images of 18 patients with ALS and 18 age-matched normal controls were scored and compared. Six patients had serial MR imaging scans within 97 days. Mann Whitney U statistics and ANOVA were used for statistical analysis.


RESULTS
Hyperintensity in the subcortical white matter (SWM) and the dark line along the posterior rim of the precentral gyri were found more frequently in patients with ALS. The scores for these two signs were significantly different from those of normal controls. Hyperintensity in the corticospinal tract (CST) was found in both ALS and normal controls, but the difference was not statistically significant. ANOVA on the serial FLAIR studies revealed no significant difference in the scores among the series. The hyperintensity in SWM had a sensitivity of 56% and specificity of 94%, while the dark line in the motor cortex had a 74% sensitivity and 67% specificity.


CONCLUSIONS
Hyperintensity in SWM and the dark line along the posterior rim of the precentral gyri appeared more frequently in the patients with ALS. SWM hyperintensity has a better specificity in association with clinically verified ALS, while the motor dark line has a better sensitivity. No correlation was found between the FLAIR findings and progression of the disease.
Department of Radiology, Weill Medical College of Cornell University, New York, New York 10021, USA.
Lijuan
L
Zhang
Aziz M
AM
Ulug
Robert D
RD
Zimmerman
Michael T
MT
Lin
Michael
M
Rubin
M Flint
MF
Beal
D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis*; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity