Detection of Multiple Sclerosis Lesions in Supra- and Infra-Tentorial Anatomical Regions by Double Inversion Recovery, Flair, and T2 MRI Sequences: A Comparative Study in Iraqi Patients

Mahmood Mishaal Mohamed; Maryam Issa Al-Ani; Gheyath Al Gawwam; Murtadha Hussein Alrubaye; Ahmed Al-Imam

doi:10.54133/ajms.v5i1S.357

Authors

Mahmood Mishaal Mohamed Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0000-0002-3635-7891
Maryam Issa Al-Ani Department of General Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq
Gheyath Al Gawwam Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
Murtadha Hussein Alrubaye Regional Hospital Gødstrup, The Hospital Park 15, 7400 Herning, Denmark
Ahmed Al-Imam Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad 10047, Iraq; Alumni Ambassador, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK https://orcid.org/0000-0003-1846-9424

DOI:

https://doi.org/10.54133/ajms.v5i1S.357

Keywords:

Double inversion recovery sequence, FLAIR sequence, Multiple sclerosis, T2 weighted image

Abstract

Background: In young adults, multiple sclerosis is a prevalent chronic inflammatory demyelinating condition. It is characterized by white matter affection, but many individuals also have significant gray matter involvement. A double-inversion recovery pulse (DIR) pattern was recently proposed to improve the visibility of multiple sclerosis lesions. Objective: To find out how well a DIR sequence, FLAIR, and T2-weighted pulse sequences can find MS lesions in the supratentorial and infratentorial regions. Methods: A total of 37 patients with established diagnoses of multiple sclerosis were included in this cross-sectional study. Brain MRI was done using double inversion recovery, T2, and FLAIR sequences. The number of lesions was counted and compared in the three sequences. Results: The DIR sequence detected more infratentorial lesions when compared to the T2 and FLAIR sequences. In the supratentorial region, DIR detected more lesions than T2 and FLAIR. Conclusion: The DIR sequence is highly superior to both the T2 and FLAIR sequences in depicting the lesions, regardless of their anatomical distribution. Moreover, the DIR sequence detected more multiple sclerosis lesions in the infratentorial region than the traditional T2W and FLAIR sequences.

Downloads

Download data is not yet available.

References

Peterson JW, Trapp BD. Neuro-pathobiology of multiple sclerosis. Neurol Clin. 2005;23: 107-129. doi: 10.1016/j.ncl.2004.09.008. DOI: https://doi.org/10.1016/j.ncl.2004.09.008

Faizy TD, Thaler C, Ceyrowski T, Broocks G, Treffler N, Sedlacik J, et al. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period. PLoS One. 2017;12(2):e0172923. doi: 10.1371/journal.pone.0172923. DOI: https://doi.org/10.1371/journal.pone.0172923

Brownlee WJ, Hardy TA, Fazekas F, Miller DH. Diagnosis of multiple sclerosis: progress and challenges. Lancet. 2017;389(10076):1336-1346. doi: 10.1016/S0140-6736(16)30959-X. DOI: https://doi.org/10.1016/S0140-6736(16)30959-X

Learningneuroradiology.com - Lobar Anatomy. Sites.google.com. 2022 [accessed in 31 January 2022]. Available from: https://sites.google.com/a/wisc.edu/neuroradiology/anatomy/underpin/ct.

Aminoff M, Greenberg D, Simon R, (Eds.), Clinical Neurology, (10th ed.) McGraw-Hill Education; 2018. https://accessmedicine.mhmedical.com/book.aspx?bookid=2274

Filippi M, RoccaMA, Ciccarelli O. MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines. Lancet Neurol. 2016;15(3):292–303. doi: 10.1016/S1474-4422(15)00393-2. DOI: https://doi.org/10.1016/S1474-4422(15)00393-2

Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the Mc Donald criteria. Lancet Neurol. 2018;17(2):162-173. doi: 10.1016/S1474-4422(17)30470-2. DOI: https://doi.org/10.1016/S1474-4422(17)30470-2

Arrambide G, Tintore M, Espejo C. The value of oligoclonal bands in the multiple sclerosis diagnostic criteria. Brain. 2018;141(4):1075-1084. doi: 10.1093/brain/awy006. DOI: https://doi.org/10.1093/brain/awy006

Wattjes MP, Rovira À, Miller D. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis--establishing disease prognosis and monitoring patients. Nat Rev Neurol. 2015;11:597–606. doi: 10.1038/nrneurol.2015.157. DOI: https://doi.org/10.1038/nrneurol.2015.157

Hemond CC, Bakshi R. Magnetic resonance imaging in multiple sclerosis. Cold Spring Harbor Perspect Med. 2018;8(5):a028969. doi: 10.1101/cshperspect.a028969. DOI: https://doi.org/10.1101/cshperspect.a028969

Elhussein N, Alazmi N, Fadulemulla IA, Hamd ZY, Ahmed AM, Seifeldin SA, et al. Comparative between double inversion recovery and fluid-attenuated inversion recovery sequences for detection of brain multiple sclerosis. Clin Cancer Investig J. 2022;11(6):41-44. doi: 10.51847/zaqwkTGLhH. DOI: https://doi.org/10.51847/zaqwkTGLhH

Hamed W, Fathi W, Mahmoud W, Elhawary G. Diagnostic accuracy of double inversion recovery in delineation of multiple sclerosis lesions and its clinical correlation with expanded disability scoring system. Egypt J Radiol Nucl Med. 2019;50(1):1-8. doi: 10.1186/s43055-019-0057-0. DOI: https://doi.org/10.1186/s43055-019-0057-0

Turetschek K, Wunderbaldinger P, Bankier AA, Zontsich T, Graf O, Mallek R, et al. Double inversion recovery imaging of the brain: initial experience and comparison with fluid attenuated inversion recovery imaging. Magnet Reson Imag. 1998;16(2):127-135. doi: 10.1016/S0730-725X(97)00254-3. DOI: https://doi.org/10.1016/S0730-725X(97)00254-3

Elkholy FS, Abdallah M, Edrees M, Edward R. Comparative study between double inversion recovery (DIR) and fluid-attenuated inversion recovery (FLAIR) MRI sequences for detection of cerebral lesions in multiple sclerosis. Egypt J Radiol Nucl Med. 2020;51:188. doi: 10.1186/s43055-020-00298-9. DOI: https://doi.org/10.1186/s43055-020-00298-9

Elnekeidy AM, Kamal MA, Elfatatry AM, Elskeikh ML. Added value of double inversion recovery magnetic resonance sequence in detection of cortical and white matter brain lesions in multiple sclerosis. Egypt J Radiol Nucl Med. 2014;45(4):1193-1199. doi: 10.1016/j.ejrnm.2014.06.010. DOI: https://doi.org/10.1016/j.ejrnm.2014.06.010

Abidi Z, Faeghi F, Mardanshahi Z, Mortazavi H. Assessment of the diagnostic accuracy of double inversion recovery sequence compared with FLAIR and T2W_TSE in detection of cerebral multiple sclerosis lesions. Electronic Physic. 2017;9; (4):4162. doi: 10.19082/4162. DOI: https://doi.org/10.19082/4162

Mohsen YM, Abdel Ghany HS, Abdelsamie MA, Saleh RN. Advanced magnetic resonance imaging (MRI) technique (double inversion recovery sequence) in the diagnosis of multiple sclerosis (MS) grey matter lesions. MJMR. 2023;34:65-75. doi: 10.21608/mjmr.2023.182262.1251. DOI: https://doi.org/10.21608/mjmr.2023.182262.1251

Simon B, Schmidt S, Lukas C, Gieseke J, Träber F, Knol DL, et al. Improved in vivo detection of cortical lesions in multiple sclerosis using double inversion recovery MR imaging at 3 Tesla. Eur Radiol. 2010; 20(7):1675-683. doi: 10.1007/s00330-009-1705-y. DOI: https://doi.org/10.1007/s00330-009-1705-y

Abdelrahman AS, Khater NH, Barakat MMK. Diagnostic utility of 3D DIR MRI in the estimation of MS lesions overall load with special emphasis on cortical subtypes. Egypt J Radiol Nucl Med. 2022;53:47. doi: 10.1186/s43055-022-00719-x. DOI: https://doi.org/10.1186/s43055-022-00719-x

Almutairi A, Hassan H, Suppiah S, Alomair O, Alshoaibi A, Almutairi H, et al. Lesion load assessment among multiple sclerosis patient using DIR, FLAIR, and T2WI sequences. Egypt J Radiol Nucl Med. 2020;51(1):128-32. doi: 10.1186/s43055-020-00312-0. DOI: https://doi.org/10.1186/s43055-020-00312-0