MS cortical lesions on DIR: not quite what they seem?

<h4>Objective</h4>Accurate identification and localization of cortical gray matter (CGM) lesions in MS is important when determining their clinical relevance. Double inversion recovery (DIR) scans have been widely used to detect MS CGM lesions. Phase sensitive inversion recovery (PSIR) s...

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Autores principales:	Varun Sethi, Nils Muhlert, Maria Ron, Xavier Golay, Claudia A Wheeler-Kingshott, David H Miller, Declan T Chard, Tarek A Yousry
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/27d2c71cd71449e882e973627e166c29
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spelling	oai:doaj.org-article:27d2c71cd71449e882e973627e166c292021-11-18T08:47:30ZMS cortical lesions on DIR: not quite what they seem?1932-620310.1371/journal.pone.0078879https://doaj.org/article/27d2c71cd71449e882e973627e166c292013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24244381/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Accurate identification and localization of cortical gray matter (CGM) lesions in MS is important when determining their clinical relevance. Double inversion recovery (DIR) scans have been widely used to detect MS CGM lesions. Phase sensitive inversion recovery (PSIR) scans have a higher signal to noise, and can therefore be obtained at a higher resolution within clinically acceptable times. This enables detection of more CGM lesions depicting a clearer cortical and juxtacortical anatomy. In this study, we systematically investigated if the use of high resolution PSIR scans changes the classification of CGM lesions, when compared with standard resolution DIR scans.<h4>Methods</h4>60 patients [30 RR(Relapsing remitting) and 15 each with PP(Primary progressive) and SP(Secondary progressive) MS] were scanned on a 3T Philips Achieva MRI scanner. Images acquired included DIR (1×1×3 mm resolution) and PSIR (0.5×0.5×2 mm). CGM lesions were detected and classified on DIR as intracortical (IC) or leucocortical (LC). We then examined these lesions on corresponding slices of the high resolution PSIR scans and categorized them as IC, LC, Juxtacortical white matter (JC-WM, abutting but not entering cortex) and other white matter (WM, not juxtacortical). Classifications using both scans were noted.<h4>Results</h4>282 IC and 483 LC were identified on DIR. Of the IC lesions, 61% were confirmed as IC on PSIR, 35.5% were reclassified as LC and 3.5% as JC-WM or other WM only. Of the LC DIR lesions, 43.9% were confirmed at LC on PSIR, 16.1% were reclassified as IC and 40% as JC-WM or other WM only. Overall, 50% (381/765) of CGM lesions seen on DIR were reclassified, and 26.5% (203/765) affected WM only.<h4>Conclusions</h4>When compared with higher resolution PSIR, a significant proportion of lesions classified as involving CGM on DIR appear to either contain more white matter than expected or to not involve CGM at all.Varun SethiNils MuhlertMaria RonXavier GolayClaudia A Wheeler-KingshottDavid H MillerDeclan T ChardTarek A YousryPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e78879 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Varun Sethi Nils Muhlert Maria Ron Xavier Golay Claudia A Wheeler-Kingshott David H Miller Declan T Chard Tarek A Yousry MS cortical lesions on DIR: not quite what they seem?
description	<h4>Objective</h4>Accurate identification and localization of cortical gray matter (CGM) lesions in MS is important when determining their clinical relevance. Double inversion recovery (DIR) scans have been widely used to detect MS CGM lesions. Phase sensitive inversion recovery (PSIR) scans have a higher signal to noise, and can therefore be obtained at a higher resolution within clinically acceptable times. This enables detection of more CGM lesions depicting a clearer cortical and juxtacortical anatomy. In this study, we systematically investigated if the use of high resolution PSIR scans changes the classification of CGM lesions, when compared with standard resolution DIR scans.<h4>Methods</h4>60 patients [30 RR(Relapsing remitting) and 15 each with PP(Primary progressive) and SP(Secondary progressive) MS] were scanned on a 3T Philips Achieva MRI scanner. Images acquired included DIR (1×1×3 mm resolution) and PSIR (0.5×0.5×2 mm). CGM lesions were detected and classified on DIR as intracortical (IC) or leucocortical (LC). We then examined these lesions on corresponding slices of the high resolution PSIR scans and categorized them as IC, LC, Juxtacortical white matter (JC-WM, abutting but not entering cortex) and other white matter (WM, not juxtacortical). Classifications using both scans were noted.<h4>Results</h4>282 IC and 483 LC were identified on DIR. Of the IC lesions, 61% were confirmed as IC on PSIR, 35.5% were reclassified as LC and 3.5% as JC-WM or other WM only. Of the LC DIR lesions, 43.9% were confirmed at LC on PSIR, 16.1% were reclassified as IC and 40% as JC-WM or other WM only. Overall, 50% (381/765) of CGM lesions seen on DIR were reclassified, and 26.5% (203/765) affected WM only.<h4>Conclusions</h4>When compared with higher resolution PSIR, a significant proportion of lesions classified as involving CGM on DIR appear to either contain more white matter than expected or to not involve CGM at all.
format	article
author	Varun Sethi Nils Muhlert Maria Ron Xavier Golay Claudia A Wheeler-Kingshott David H Miller Declan T Chard Tarek A Yousry
author_facet	Varun Sethi Nils Muhlert Maria Ron Xavier Golay Claudia A Wheeler-Kingshott David H Miller Declan T Chard Tarek A Yousry
author_sort	Varun Sethi
title	MS cortical lesions on DIR: not quite what they seem?
title_short	MS cortical lesions on DIR: not quite what they seem?
title_full	MS cortical lesions on DIR: not quite what they seem?
title_fullStr	MS cortical lesions on DIR: not quite what they seem?
title_full_unstemmed	MS cortical lesions on DIR: not quite what they seem?
title_sort	ms cortical lesions on dir: not quite what they seem?
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/27d2c71cd71449e882e973627e166c29
work_keys_str_mv	AT varunsethi mscorticallesionsondirnotquitewhattheyseem AT nilsmuhlert mscorticallesionsondirnotquitewhattheyseem AT mariaron mscorticallesionsondirnotquitewhattheyseem AT xaviergolay mscorticallesionsondirnotquitewhattheyseem AT claudiaawheelerkingshott mscorticallesionsondirnotquitewhattheyseem AT davidhmiller mscorticallesionsondirnotquitewhattheyseem AT declantchard mscorticallesionsondirnotquitewhattheyseem AT tarekayousry mscorticallesionsondirnotquitewhattheyseem
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MS cortical lesions on DIR: not quite what they seem?

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