title: Diagnostic value of 3D fluid attenuated inversion recovery sequence in multiple sclerosis.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) is an indispensable tool in the diagnostic work-up of multiple sclerosis (MS). To date, guidelines suggest MRI protocols containing axial dual-echo, unenhanced and post-contrast T1-weighted sequences. Especially the usage of dual-echo sequences has markedly improved the ability of MRI to detect cortical and infratentorial lesions. Newer 3D FLAIR sequences are supposed to provide even more positive imaging features such as improved detection of white matter lesions and a better resolution due to smaller slice thickness.
  
  
  OBJECTIVE
  To evaluate the diagnostic impact of 3D FLAIR sequences in comparison to conventional T2 and PD sequences.
  
  
  METHODS
  Examinations of 20 MS patients (10 women, 10 men) were reviewed retrospectively. All patients received MRI standard protocol containing PD and T2 sequences and a mid-sagittal T2 sequence. Additionally an isotropic 3D FLAIR sequence was performed. Whole-brain lesion load and number of lesions in juxtacortical, infratentorial, and midcallosal localizations were assessed by two observers independently and compared.
  
  
  RESULTS
  Whole lesion load and the count of detectable lesions at the 3D FLAIR sequence were significantly higher in the juxtacortical and infratentorial regions compared to the PD/T2 sequence. Detection rate of midcallosal lesions did not differ significantly in sagittal T2 and 3D FLAIR sequence.
  
  
  CONCLUSIONS
  3D FLAIR sequences can improve the detection of brain lesions in patients with MS and are even more sensitive in depicting lesions in cortical and infratentorial locations than current dual-echo sequences. The sequence can replace both PD/T2 sequences and mid-sagittal T2 sequences of the corpus callosum.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany carolin.gramsch@uk-essen.de.
authors.forename: Carolin
authors.initials: C
authors.lastname: Gramsch
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Nensa
authors.affiliation: Department of Neurology, University Hospital Essen, Essen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kastrup
authors.affiliation: Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Maderwald
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Deuschl
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Ringelstein
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Schelhorn
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Forsting
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Schlamann
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D015588:Observer Variation; D012189:Retrospective Studies; D055815:Young Adult
keywords: 3D FLAIR; MRI; Multiple sclerosis