Diagnostic value of gadolinium contrast administration for spinal cord magnetic resonance imaging in multiple sclerosis patients and correlative markers of lesion enhancement

被引:1
作者
Karimian-Jazi, Kianush [1 ]
Neuberger, Ulf [1 ]
Schregel, Katharina [1 ]
Brugnara, Gianluca [1 ]
Bendszus, Martin [1 ]
Breckwoldt, Michael O. [1 ]
Schwarz, Daniel [1 ]
Jager, Laura Bettina [2 ]
Wick, Wolfgang [2 ,3 ,4 ]
机构
[1] Univ Hosp Heidelberg, Dept Neuroradiol, Neuenheimer Feld 400, D-69120 Heidelberg, Germany
[2] Univ Hosp Heidelberg, Neurol Clin, Heidelberg, Germany
[3] German Canc Res Ctr, Clin Cooperat Unit Neurooncol, German Canc Consortium DKTK, Heidelberg, Germany
[4] Univ Hosp Heidelberg, Natl Ctr Tumor Dis, Heidelberg, Germany
关键词
Multiple sclerosis; spinal magnetic resonance imaging; gadolinium-based contrast agents; T2 signal ratio; gadolinium depositions; SIGNAL INTENSITY; DENTATE NUCLEUS; MRI; IMAGES; BRAIN;
D O I
10.1177/20552173211047978
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Magnetic resonance imaging is essential for monitoring people with multiple sclerosis, but the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging is unclear. Objective To assess the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging follow-up examinations and identify imaging markers correlating with lesion enhancement. Methods A total of 65 multiple sclerosis patients with at least 2 spinal magnetic resonance imaging follow-up examinations were included. Spine magnetic resonance imaging was performed at 3 Tesla with a standardized protocol (sagittal and axial T2-weighted turbo spin echo and T1-weighted post-contrast sequences). T2 lesion load and enhancing lesions were assessed by two independent neuroradiologists for lesion size, localization, and T2 signal ratio (T2 signal(lesion)/T2 signal(normal appearing spinal cord)). Results A total of 68 new spinal T2 lesions and 20 new contrast-enhancing lesions developed during follow-up. All enhancing lesions had a discernable correlate as a new T2 lesion. Lesion enhancement correlated with a higher T2 signal ratio compared to non-enhancing lesions (T2 signal ratio: 2.0 +/- 0.4 vs. 1.4 +/- 0.2, ****p < 0.001). Receiver operating characteristics analysis showed an optimal cutoff value of signal ratio 1.78 to predict lesion enhancement (82% sensitivity and 97% specificity). Conclusion Gadolinium contrast administration is dispensable in follow-up spine magnetic resonance imaging if no new T2 lesions are present. Probability of enhancement correlates with the T2 signal ratio.
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