Matthew Louis White MD, Presenter: Nothing to Disclose

Tilman Koelsch, Abstract Co-Author: Nothing to Disclose

Fang Yu, Abstract Co-Author: Nothing to Disclose

Yan Zhang MD, Abstract Co-Author: Nothing to Disclose

Kathleen Healey, Abstract Co-Author: Nothing to Disclose

David M Penn MD, Abstract Co-Author: Nothing to Disclose

Multiple Sclerosis spinal cord lesions are visualized by MRI in 42-87% of patients. Technological improvements and new sequences are resulting in improved MRI contrast and likely improved lesion detection. Also, there have been discrepancies in the literature on the distribution of spinal cord plaques. The purpose of this study was to determine the lesion distribution in our MS patient population on axial versus sagittal planes of imaging.  

Forty-nine patients who received a cervical spine MRI for a clinical diagnosis of MS were retrospectively analyzed. The population consisted of 12 males and 37 females, ages of 19 to 63. MRI imaging was performed with a 3T GE HDx MRI with an 8 channel HD phased-array spine coil. Images were reviewed using sagittal T2 FS (fat-saturated), and axial T2 MERGE (Multiple-Echo Recombined Gradient Echo) sequences. One reader counted focal lesions. They were blinded to clinical data at the time of evaluation. A logistic regression model on the data was used to compare the lesions detected by the different imaging planes.  

Cervical spinal imaging of forty-five patients showed 106 lesions on the sagittal T2 FS sequence, and 171 lesions on axial MERGE sequence. Statistical analysis demonstrated that there is significant difference between the lesions detected in the different imaging plane (p<0.001). 60% of lesions were located at C1-C3 on the axial MERGE sequence. The sagittal T2 FS had a lower percentage of lesions (46%) at the C1-C3 spinal levels. The peak number of lesions were located at C2 (40 lesions) on the axial MERGE images and at C3 (21 lesions) on the sagittal T2 FS images.

This study showed a more cranial distribution of lesions in the cervical spine when compared to previous studies particularly based on axial MERGE sequence. A prior study found approximately 60% of lesions in the C3-C5 level, which is more similar to the distribution seen on the sagittal plane in this study. The peak number of lesions on the axial MERGE was at C2 which is higher than has been reported. This suggests that utilizing axial MERGE provides useful information on the disease burden versus viewing only a sagittal T2 FS.

Demonstrates the importance of evaluating MS cervical spine lesion distribution with an axial MERGE sequence.

White, M, Koelsch, T, Yu, F, Zhang, Y, Healey, K, Penn, D, Multiple Sclerosis Lesion Distribution in the Cervical Spine and Variation Based on Imaging Technique: A 3 T MRI 2D Multi-Echo Recombined Gradient Echo MR Imaging Study.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012627.html