Comparison between gadolinium-enhanced 2D T1-weighted gradient-echo and spin-echo sequences in the detection of active multiple sclerosis lesions on 3.0T MRI.
OBJECTIVES
To compare the sensitivity of enhancing multiple sclerosis (MS) lesions in gadolinium-enhanced 2D T1-weighted gradient-echo (GRE) and spin-echo (SE) sequences, and to assess the influence of visual conspicuity and laterality on detection of these lesions.


METHODS
One hundred MS patients underwent 3.0T brain MRI including gadolinium-enhanced 2D T1-weighted GRE and SE sequences. The two sets of contrast-enhanced scans were evaluated in random fashion by three experienced readers. Lesion conspicuity was assessed by the image contrast ratio (CR) and contrast-to-noise ratio (CNR). The intracranial region was divided into four quadrants and the impact of lesion location on detection was assessed in each slice.


RESULTS
Six hundred and seven gadolinium-enhancing MS lesions were identified. GRE images were more sensitive for lesion detection (0.828) than SE images (0.767). Lesions showed a higher CR in SE than in GRE images, whereas the CNR was higher in GRE than SE. Most misclassifications occurred in the right posterior quadrant.


CONCLUSIONS
The gadolinium-enhanced 2D T1-weighted GRE sequence at 3.0T MRI enables detection of enhancing MS lesions with higher sensitivity and better lesion conspicuity than 2D T1-weighted SE. Hence, we propose the use of gadolinium-enhanced GRE sequences rather than SE sequences for routine scanning of MS patients at 3.0T.


KEY POINTS
• 2D SE and GRE sequences are useful for detecting active MS lesions. • Which of these sequences is more sensitive at high field remains uncertain. • GRE sequence showed better sensitivity for detecting active MS lesions than SE. • We propose GRE sequence for detecting active MS lesions at 3.0T.
['Aymerich|F X|FX|http://orcid.org/0000-0002-6129-9208', 'Auger|C|C|', 'Alcaide-Leon|P|P|', 'Pareto|D|D|', 'Huerga|E|E|', 'Corral|J F|JF|', 'Mitjana|R|R|', 'Sastre-Garriga|J|J|', 'Montalban|X|X|', 'Rovira|A|A|']
D000293:Adolescent D000328:Adult D001921:Brain D003287:Contrast Media D005260:Female D006801:Humans D007089:Image Enhancement D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009103:Multiple Sclerosis D009942:Organometallic Compounds D015203:Reproducibility of Results D012680:Sensitivity and Specificity D055815:Young Adult
Multiple sclerosis Brain Lesion conspicuity Contrast sensitivity Magnetic resonance imaging