Mike P. Wattjes MD, Presenter: Nothing to Disclose

Michael Harzheim MD, Abstract Co-Author: Nothing to Disclose

Goetz Gerhard Lutterbey MD, Abstract Co-Author: Nothing to Disclose

Juergen Gieseke, Abstract Co-Author: Nothing to Disclose

Christiane Katharina Kuhl MD, Abstract Co-Author: Nothing to Disclose

Luisa Klotz MD, Abstract Co-Author: Nothing to Disclose

Thomas Klockgether MD, Abstract Co-Author: Nothing to Disclose

Hans Heinz Schild MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To investigate the detection rates of inflammatory lesions in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS) at 1.5T and 3.0T an analyse the effect on the classification according to Barkhof MRI and McDonald diagnostic criteria.

We performed an intraindivdual comparative study in patients with the clinical diagnosis of CIS suggestive of MS. The imaging protocol included contiguous axial slices with the following pulse sequences: T2 Turbo Spinecho (1.5T: TE 100ms, TR 3500ms; 3.0T: TE 100ms, TR 4100ms), FLAIR (1.5T: TE 110ms, TR 6000ms, TI 2000ms; 3.0T: TE 140ms, TR 12000ms, TI 2850ms) und T1 Spinecho (1.5T und 3.0T: TE 12ms, TR 500ms) before and after intravenous injection of gadolinium-DTPA. For both field strengths constant resolution parameters were used. High signal white matter lesions with a size of at least 3mm were counted and categorized according to their anatomic location in infratentorial, callosal, juxtacortical, periventricular and other white matter. Assessment of the fulfilled Barkhof MRI and McDonald diagnostic criteria for both field strengths in every patient.

40 patients (10 male, 30 female, 18-55 years, EDSS 0-3) were included. Significant higher detection rates on the FLAIR and T2 TSE images at 3.0T were observed. Concerning the FLAIR images, 373 lesions were identified at 3.0T and 329 lesions at 1.5T. Regarding the T2 TSE images, 323 lesion were seen at 3.0T and 287 lesions at 1.5T. These higher lesion measurements were significant for the infratentorial, juxtacortical and periventricular region. This resulted in an increased number of fulfilled Barkhof MRI criteria in 11 patients. Among those, 2 patients crossed the diagnostic cut off point of 3 out of 4 MRI criteria leading to the diagnosis of dissemination in space according to the McDonald diagnostic criteria.

The higher lesion load measurement of inflammatory lesions at high-field MRI has an substantial influence on the classification of patients with CIS according to MRI and diagnostic criteria with consequences for the diagnostic work-up, clinical trials, and prognostic classification.

Wattjes, M, Harzheim, M, Lutterbey, G, Gieseke, J, Kuhl, C, Klotz, L, Klockgether, T, Schild, H, et al, , Does High-field MRI Have an Influence on the Classification of Patients with Clinically Isolated Syndromes Suggestive of Multiple Sclerosis according to Imaging and Diagnostic Criteria?.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4412224.html