title: Improved in vivo detection of cortical lesions in multiple sclerosis using double inversion recovery MR imaging at 3 Tesla.
abstract: OBJECTIVE
  To investigate the impact of a higher magnetic field strength of 3 Tesla (T) on the detection rate of cortical lesions in multiple sclerosis (MS) patients, in particular using a dedicated double inversion recovery (DIR) pulse sequence.
  
  
  METHODS
  Thirty-four patients with clinically isolated syndromes or definite MS were included. All patients underwent magnetic resonance imaging (MRI) at 1.5 T and 3 T, including T2-weighted turbo spin echo (TSE), fluid-attenuated inversion recovery (FLAIR) and DIR sequences. All images were analysed for focal lesions categorised according to their anatomical location.
  
  
  RESULTS
  The total number of detected lesions was higher at 3 T across all pulse sequences. We observed significantly higher numbers of lesions involving the cortex at 3 T using a DIR sequence. DIR at 3 T showed 192% more pure intracortical (p < 0.001) and 30% more mixed grey matter-white matter lesions (p = 0.008). No significant increase in cortical lesions could be detected on the FLAIR and T2-weighted images. Using the T2-weighted and FLAIR sequences, significantly more lesions could be detected at 3 T in the infratentorial, periventricular and juxtacortical white matter.
  
  
  CONCLUSIONS
  DIR brain MR imaging at 3 T substantially improves the sensitivity of the detection of cortical lesions compared with the standard magnetic field strength of 1.5 T.
authors.affiliation: Department of Radiology, University Hospital of Bonn, Bonn, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Simon
authors.forename: Stephan
authors.initials: S
authors.lastname: Schmidt
authors.forename: Carsten
authors.initials: C
authors.lastname: Lukas
authors.forename: Jürgen
authors.initials: J
authors.lastname: Gieseke
authors.forename: Frank
authors.initials: F
authors.lastname: Träber
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: Geurts
authors.forename: Hans H
authors.initials: HH
authors.lastname: Schild
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Mike P
authors.initials: MP
authors.lastname: Wattjes
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology; D012015:Reference Standards