title: MP2RAGE multiple sclerosis magnetic resonance imaging at 3 T.
abstract: OBJECTIVE
  Lesion detection and characterization in multiple sclerosis (MS) are an essential part of its clinical diagnosis and an important research field. In this pilot study, we applied the recently introduced two inversion-contrast magnetization-prepared rapid gradient echo sequence (MP2RAGE) to patients with early-stage MS.
  
  
  METHODS
  The MP2RAGE is a 3-dimensional (3D) magnetization-prepared rapid gradient echo derivative providing homogeneous T1 weighting and simultaneous T1 mapping. The MP2RAGE performance was compared with that of 2 clinical routine sequences (2D fluid-attenuated inversion recovery [FLAIR] and 3D magnetization-prepared rapid gradient echo [MP-RAGE]) and 2 state-of-the art clinical research sequences (the 3D FLAIR-SPACE [sampling perfection with application-optimized contrasts by using different flip-angle evolutions], a fluid-attenuated variable flip-angle fast spin echo technique, and the 3D double-inversion recovery SPACE). A cohort of 10 early-stage female MS patients (age, 31.6 ± 4.7 years; disease duration, 3.8 ± 1.9 years; median expanded disability status scale score, 1.75) and 10 age- and gender-matched controls were enrolled after approval of the local institutional review board was obtained. Multiple sclerosis lesions were identified and assigned to brain locations and tissue types by two experienced physicians in all 5 contrasts. Subsequently, lesions were manually delineated for comparison and statistical analysis of lesion count, volume and quantitative measures.
  
  
  CONCLUSIONS
  The results show that the 3D T1-weighted high-resolution MP2RAGE contrast provides a sensitive means for MS lesion assessment. The additional quantitative T1 relaxation time maps obtained with the MP2RAGE provide further potential diagnostic and prognostic information that could help (a) to better discriminate lesion subtypes and (b) to stage and predict the activity and the evolution of MS. Results also indicate that the T2-weighted double-inversion recovery and FLAIR-SPACE contrasts are attractive complements to the MP2RAGE for lesion detection.
authors.affiliation: Siemens Schweiz AG, Healthcare Sector IM&WS S, Renens, Switzerland. tobias.kober@epfl.ch
authors.forename: Tobias
authors.initials: T
authors.lastname: Kober
authors.forename: Cristina
authors.initials: C
authors.lastname: Granziera
authors.forename: Delphine
authors.initials: D
authors.lastname: Ribes
authors.forename: Patrick
authors.initials: P
authors.lastname: Browaeys
authors.forename: Myriam
authors.initials: M
authors.lastname: Schluep
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.forename: Richard
authors.initials: R
authors.lastname: Frackowiak
authors.forename: Rolf
authors.initials: R
authors.lastname: Gruetter
authors.forename: Gunnar
authors.initials: G
authors.lastname: Krueger
mesh_terms: D000328:Adult; D000465:Algorithms; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009103:Multiple Sclerosis / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity