Comparison of Susceptibility-Weighted Imaging with Contrast Enhancement in Detection of Multiple Sclerosis Active Plaques using 1.5 Tesla Magnetic Resonance Imaging System

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Magnetic resonance imaging with contrast enhancement (CE) is an essential method in the detection of active multiple sclerosis (MS) plaques. Nevertheless, in patients who are contraindicated with gadolinium, this method is not possible, and needs to be replaced. Susceptibility-weighted imaging (SWI) has been reported to be effective in detecting MS plaques, but its ability to detect active plaques is unclear.Methods: This cross-sectional study was performed on 147 patients with MS in Shafa Imaging Center, Isfahan, Iran, using 1.5 Tesla magnetic resonance imaging (MRI) System. In addition to conventional MRI sequences including T1, T2, FLAIR and CE-T1W, SWI sequences were also obtained. Then, the images of contrast enhancement, final SWI, and magnitude were examined and signal intensity was measured by drawing return on investment (ROI) in three areas of active plaque, passive plaque, and background.Findings: From 147 patients, 32 had active plaque. There was a direct and significant relationship between final SWI with CE as well as between magnitude and CE (P < 0.001). The final SWI had a sensitivity of 71.87 and a specificity of 91.30; and a magnitude of SWI had a sensitivity of 75 and a specificity of 87.83 in detecting active plaques. Moreover, the accuracy of determination of active plaques was 87.07% for final SWI and 85.03% for large-size ones.Conclusion: The results of our study show that SWI method is capable of detecting MS plaques with high sensitivity, specificity, and accuracy, and distinguishes active plaques from passive plaques as well.

Keywords

References

  1. Tajouri L, Martin V, Gasparini C, Ovcaric M, Curtain R, Lea RA, et al. Genetic investigation of methylenetetrahydrofolate reductase (MTHFR) and catechol-O-methyl transferase (COMT) in multiple sclerosis. Brain Res Bull 2006; 69(3): 327-31.
  2. Farshchian N, Razazian N, Rezaei M, Livani S. Signal intensity of basal ganglions in T2 magnetic resonance imaging in multiple sclerosis. J Gorgan Univ Med Sci 2012; 14(4): 76-81. [In Persian].
  3. Krauss W, Gunnarsson M, Nilsson M, Thunberg P. Conventional and synthetic MRI in multiple sclerosis: A comparative study. Eur Radiol 2018; 28(4): 1692-700.
  4. Bagheri MH, Meshksar A, Nabavizadeh SA, Borhani-Haghighi A, Ashjazadeh N, Nikseresht AR. Diagnostic value of contrast-enhanced fluid-attenuated inversion-recovery and delayed contrast-enhanced brain MRI in multiple sclerosis. Acad Radiol 2008; 15(1): 15-23.
  5. Thomsen HS. Guidelines for contrast media from the European Society of Urogenital Radiology. AJR Am J Roentgenol 2003; 181(6): 1463-71.
  6. Kanal E, Borgstede JP, Barkovich AJ, Bell C, Bradley WG, Etheridge S, et al. American College of Radiology White Paper on MR Safety: 2004 update and revisions. AJR Am J Roentgenol 2004; 182(5): 1111-4.
  7. Hammond KE, Metcalf M, Carvajal L, Okuda DT, Srinivasan R, Vigneron D, et al. Quantitative in vivo magnetic resonance imaging of multiple sclerosis at 7 Tesla with sensitivity to iron. Ann Neurol 2008; 64(6): 707-13.
  8. Zivadinov R, Schirda C, Dwyer MG, Haacke ME, Weinstock-Guttman B, Menegatti E, et al. Chronic cerebrospinal venous insufficiency and iron deposition on susceptibility-weighted imaging in patients with multiple sclerosis: A pilot case-control study. Int Angiol 2010; 29(2): 158-75.
  9. Haacke EM, Makki M, Ge Y, Maheshwari M, Sehgal V, Hu J, et al. Characterizing iron deposition in multiple sclerosis lesions using susceptibility weighted imaging. J Magn Reson Imaging 2009; 29(3): 537-44.
  10. Ge Y, Zohrabian VM, Osa EO, Xu J, Jaggi H, Herbert J, et al. Diminished visibility of cerebral venous vasculature in multiple sclerosis by susceptibility-weighted imaging at 3.0 Tesla. J Magn Reson Imaging 2009; 29(5): 1190-4.
  11. Eissa A, Lebel RM, Korzan JR, Zavodni AE, Warren KG, Catz I, et al. Detecting lesions in multiple sclerosis at 4.7 tesla using phase susceptibility-weighting and T2-weighting. J Magn Reson Imaging 2009; 30(4): 737-42.
  12. Haacke EM, Mittal S, Wu Z, Neelavalli J, Cheng YC. Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. AJNR Am J Neuroradiol 2009; 30(1): 19-30.
  13. Zivadinov R, Heininen-Brown M, Schirda CV, Poloni GU, Bergsland N, Magnano CR, et al. Abnormal subcortical deep-gray matter susceptibility-weighted imaging filtered phase measurements in patients with multiple sclerosis: A case-control study. Neuroimage 2012; 59(1): 331-9.
  14. Bagheri A, Faeghi F, Rabbani M, Jabari K. Diagnostic value of susceptibility weighted imaging in sinus venous thrombosis. Horizon Med Sci 2015; 21(3): 189-96.
  15. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol 2005; 58(6): 840-6.
  16. Shellock FG. Magnetic resonance imaging patient screening form. Pa Patient Saf Advis 2009; 6(1): 20-6.
  17. Kister I. The Multiple Sclerosis Lesion Checklist. Practical Neurology 2018; 718: 68-73.
  18. Grabner G, Dal-Bianco A, Schernthaner M, Vass K, Lassmann H, Trattnig S. Analysis of multiple sclerosis lesions using a fusion of 3.0 T FLAIR and 7.0 T SWI phase: FLAIR SWI. J Magn Reson Imaging 2011; 33(3): 543-9.
  19. Guttmann CR, Ahn SS, Hsu L, Kikinis R, Jolesz FA. The evolution of multiple sclerosis lesions on serial MR. AJNR Am J Neuroradiol 1995; 16(7): 1481-91.
  20. Janardhan V, Suri S, Bakshi R. Multiple sclerosis: hyperintense lesions in the brain on nonenhanced T1-weighted MR images evidenced as areas of T1 shortening. Radiology 2007; 244(3): 823-31.
  21. Suzuki M, Kudo K, Sasaki M, Takahashi S, Takahashi J, Fujima N, et al. Detection of active plaques in multiple sclerosis using susceptibility-weighted imaging: comparison with gadolinium-enhanced MR imaging. Magn Reson Med Sci 2011; 10(3): 185-92.
  22. Hosseini Z, Matusinec J, Rudko DA, Liu J, Kwan BYM, Salehi F, et al. Morphology-specific discrimination between ms white matter lesions and benign white matter hyperintensities using ultra-high-field MRI. AJNR Am J Neuroradiol 2018; 39(8): 1473-9.
Journal of Isfahan Medical School
Volume 37, Issue 538 - Serial Number 538
July and August 2019
Pages 931-936

Files

History

  • Receive Date: 02 September 2019
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics