title: Detection of active plaques in multiple sclerosis using susceptibility-weighted imaging: comparison with gadolinium-enhanced MR imaging.
abstract: OBJECTIVE
  Susceptibility-weighted (SW) imaging is a magnetic resonance (MR) imaging technique reported effective in visualizing multiple sclerosis (MS) plaques, but its capacity to distinguish active plaques remains unclear. We evaluated active plaque detection by SW compared with contrast-enhanced MR imaging.
  
  
  METHODS
  We prospectively examined 11 patients using a 3-tesla scanner. Two neuroradiologists independently evaluated signal changes of plaques and accompanying low signal rims in 74 plaques on various SW images (magnitude, phase, and minimum intensity projection [minIP]), and on contrast-enhanced T(1)-weighted images (T(1)WI). We correlated signal alterations on various SW images and contrast enhancement on T(1)WI using Fisher's exact test and calculated sensitivity and specificity for predicting gadolinium enhancement.
  
  
  RESULTS
  Only changes in plaque signal on SW magnitude images correlated significantly with contrast enhancement of the plaques (P=0.008), and high signal intensity had 0.556 sensitivity and 0.787 specificity for predicting contrast-enhanced plaques. Furthermore, plaques with rims of low signal showed sensitivity of 0.296 and specificity of 0.957.
  
  
  CONCLUSIONS
  Susceptibility-weighted magnitude, but not phase or minIP, images can predict MS plaques with contrast enhancement with high specificity.
authors.affiliation: Department of Neurology, Iwate Medical University, Morioka, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Suzuki
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Jyunko
authors.initials: J
authors.lastname: Takahashi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Fujima
authors.forename: Ikuko
authors.initials: I
authors.lastname: Uwano
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yonezawa
authors.forename: Masako
authors.initials: M
authors.lastname: Kudo
authors.forename: Hikoaki
authors.initials: H
authors.lastname: Fukaura
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishizuka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terayama
mesh_terms: D000293:Adolescent; D000328:Adult; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006571:Heterocyclic Compounds; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology; D009942:Organometallic Compounds; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium