title: Improved Lesion Detection by Using Axial T2-Weighted MRI with Full Spinal Cord Coverage in Multiple Sclerosis.
abstract: Identification of lesions in specific locations gains importance in multiple sclerosis imaging diagnostic criteria. In clinical routine, axial scans are usually exclusively obtained to depict the cervical spinal cord or used to confirm suspected lesions on sagittal scans. We sought to evaluate the detection rate for MS lesions on axial T2WI scans with full spinal cord coverage in comparison with sagittal scans.
  
  
  
  One hundred fifteen patients with definite or suspected MS underwent an MR imaging examination including 3-mm sagittal and 3.5-mm axial T2-weighted images with full spinal cord coverage. T2WI lesions were identified on axial and sagittal scans independently by 2 raters. Axial diameter, craniocaudal extension, lesion intensity, and location were analyzed.
  
  
  
  Four hundred forty-nine of 509 (88.2%) lesions were detected on axial and 337/509 (66.2%) on sagittal scans. Only 277/449 (61.7%) axial lesions were also detected on sagittal images. The number of lesions visible on sagittal and axial images was dependent on the axial lesion diameter (P < .001).
  
  
  
  Axial T2WI scans with full spinal cord coverage showed 22% more lesions in patients with MS in comparison with sagittal scans, especially for lesions with small axial diameters. We suggest including biplanar spinal MR imaging with full spinal cord coverage for lesion detection in MS in clinical routine and for clinical studies.
authors.affiliation: From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.) s.galler@uke.de.
authors.forename: S
authors.identifier: 0000-0002-8483-8737
authors.initials: S
authors.lastname: Galler
authors.affiliation: Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: J-P
authors.identifier: 0000-0003-2565-2833
authors.initials: JP
authors.lastname: Stellmann
authors.affiliation: Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: K L
authors.identifier: 0000-0002-9298-024X
authors.initials: KL
authors.lastname: Young
authors.affiliation: From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.).
authors.forename: D
authors.identifier: 0000-0002-9519-3575
authors.initials: D
authors.lastname: Kutzner
authors.affiliation: Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: C
authors.identifier: 0000-0001-8131-9467
authors.initials: C
authors.lastname: Heesen
authors.affiliation: From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.).
authors.forename: J
authors.identifier: 0000-0001-8533-7478
authors.initials: J
authors.lastname: Fiehler
authors.affiliation: From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: S
authors.identifier: 0000-0002-7444-7265
authors.initials: S
authors.lastname: Siemonsen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D013116:Spinal Cord / Q000000981:diagnostic imaging* / Q000473:pathology*; D055815:Young Adult