title: Biplanar MRI for the assessment of the spinal cord in multiple sclerosis.
abstract: OBJECTIVE
  To investigate the entire spinal cord (SC) of multiple sclerosis (MS) patients with biplanar MRI and to relate these MRI findings to clinical functional scores.
  
  
  METHODS
  Two hundred and two patients (140 women, 62 men 24-74 years, Expanded Disability Status Scale (EDSS) scores 0-7.5) were investigated clinically and with biplanar MRI. Sagittal and axial proton density weighted (PDw) and T2 weighted (T2w) images of the whole SC were obtained employing parallel imaging. Data were analyzed by consensus reading using a standardized reporting scheme. Different combinations of findings were compared to EDSS scores with Spearman's rank correlation coefficient (ρ).
  
  
  RESULTS
  The combined analysis of sagittal and axial planes demonstrated slightly differing results in 97/202 (48%) patients. There were 9% additional lesions identified, leading to a higher lesion count in 28% of these patients, but also rejection of equivocal abnormality leading to a lower lesion count in 11% of patients. Considering both sagittal and axial images, SC abnormalities were found in 167/202 (83%) patients. When compared with EDSS scores, the combination of focal lesions, signs of atrophy and diffuse abnormalities showed a moderate correlation (ρ=0.52), that precludes its use for individual patient assessment.
  
  
  CONCLUSIONS
  Biplanar MRI facilitates a comprehensive identification, localization, and grading of pathological SC findings in MS patients. This improves the confidence and utility of SC imaging.
authors.affiliation: Department of Neurology, University Hospital Basel, Basel, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Weier
authors.forename: Jilla
authors.initials: J
authors.lastname: Mazraeh
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Naegelin
authors.forename: Alain
authors.initials: A
authors.lastname: Thoeni
authors.forename: Jochen G
authors.initials: JG
authors.lastname: Hirsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Fabbro
authors.forename: Nicole
authors.initials: N
authors.lastname: Bruni
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Duyar
authors.forename: Kerstin
authors.initials: K
authors.lastname: Bendfeldt
authors.forename: Ernst-Wilhelm
authors.initials: EW
authors.lastname: Radue
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.forename: Achim
authors.initials: A
authors.lastname: Gass
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000473:pathology*; D055815:Young Adult