Gray matter-white matter contrast on spin-echo T1-weighted images at 3 T and 1.5 T: a quantitative comparison study

Discrepancies exist in the literature regarding contrast between gray and white matter on spin-echo (SE) T1-weighted MR imaging at 3 T. The present study quantitatively assessed differences in gray matter-white matter contrast on both single- and multi-slice SE T1-weighted imaging between 3 and 1.5 T. SE T1-weighted sequences with the same parameters at both 3 and 1.5 T were used. Contrast-to-noise ratio (CNR) between gray and white matter (CNR_GM-WM) was evaluated for both frontal lobes. To assess the effects of interslice gap, multi-slice images were obtained with both 0 and 25% interslice gap. Single-slice CNR_GM-WM was higher at 3 T (17.66 ± 2.68) than at 1.5 T (13.09 ± 2.35; P < 0.001). No significant difference in CNR_GM-WM of multi-slice images with 0% gap was noted between 3 and 1.5 T (3T, 8.61 ± 2.55; 1.5T, 7.43 ± 1.20; P > 0.05). Multi-slice CNR_GM-WM with 25% gap was higher at 3T (12.47 ± 3.31) than at 1.5 T (9.73 ± 1.37; P < 0.001). CNR_GM-WM reduction rate of multi-slice images with 0% gap compared with single-slice images was higher at 3T (0.47 ± 0.13) than at 1.5 T (0.38 ± 0.09; P = 0.02). CNR_GM-WM on single-slice SE T1-weighted imaging and CNR_GM-WM on multi-slice images with 25% interslice gap were better at 3 T than at 1.5 T. The influence of multi-slice imaging on CNR_GM-WM was significantly larger at 3T than at 1.5 T. This study was supported in part by a Health and Labour Sciences Research Grant of Japan Yasutaka Fushimi and Yukio Miki equally contributed to the study.     

Intraindividual comparison of myocardial delayed enhancement MR imaging using gadobenate dimeglumine at 1.5 T and 3 T

For contrast-enhanced imaging techniques relying on strong T1 weighting, 3 T provides increased contrast compared with 1.5 T. The aim of our study was the intraindividual comparison of delayed enhancement MR imaging at 1.5 T and at 3 T. Twenty patients with myocardial infarction were examined at 1.5 T and 3 T. Fifteen minutes after injection of contrast agent (0.1 mmol gadobenate dimeglumine per kg body weight), inversion recovery gradient recalled echo (IR-GRE) sequences were acquired (1.5 T/3 T: TR 11.0/9.9 ms, TE 4.4/4.9 ms, flip 30°/30°, slice thickness 6/6 mm) to assess myocardial viability. Two observers rated image quality (Wilcoxon signed rank test). Quantification of hyperenhanced myocardium and standardized SNR/CNR measurements were performed (Student’s t test). There was no significant difference with respect to image quality (1.5 T/3 T: 3.5/3.3, p = 0.34, reader 1; 2.4/2.7, p = 0.12, reader 2) and infarction size (760 ± 566/828 ± 677 mm² at 1.5 T, 808 ± 639/826 ± 726 mm² at 3 T, reader 1/reader 2, p > 0.05). Mean SNR in hyperenhanced/normal myocardium was 19.2/6.2 at 1.5 T and 29.5/8.8 at 3 T (p < 0.05). Mean CNR was 14.3 at 1.5 T and 26.0 at 3 T (p < 0.05). Delayed enhancement MR imaging at 3 T is a robust procedure yielding superior tissue contrast at 3 T compared with 1.5 T which is, however, not reflected by increased image quality.     

Efficacy of magnetic resonance imaging at 3 T compared with 1.5 T in small pituitary tumors for stereotactic radiosurgery planning

Purpose

The objective of this study was to determine the value of high-field magnetic resonance imaging and to clarify the characteristics of each image among three-dimensional gradient echo (3D-GRE), two-dimensional spin echo (2D-SE) and inversion recovery (2D-IR) sequences used as contrast-enhanced T1-weighted images for stereotactic irradiation treatment planning of sellar lesions.

Materials and methods

Pulse sequences of 2D-SE and 3D-spoiled gradient recalled acquisition in the steady state (3D-SPGR) using GRE at 1.5 T and 2D-IR and 3D-fast SPGR (3D-FSPGR) at 3 T after injection of contrast material were acquired for 14 small pituitary tumors. As quantitative methods, signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were evaluated using a region-of-interest analysis.

Results

There was no significant difference in SNR between 1.5-T SPGR and 3-T FSPGR, while 3-T IR was superior to 1.5-T SE. The 2D-SE and -IR provided significantly better CNR than 3D-GRE between tumor and normal structures.

Conclusions

Three Tesla was found to be superior to 1.5 T in distinguishing tumors from the normal sellar structure. Optimal dose planning will utilize each advantage of imaging; 3D-GRE allows high-resolution acquisition and 2D-SE and -IR can offer better tissue contrast.     

TTC post-processing is beneficial for functional MRI at low magnetic field: a comparative study at 1 T and 3 T

This study aimed to broaden the diagnostic possibilities of low-field MRI systems (i) by examining the feasibility of functional MRI of human brain activation at 1 T, and (ii) by assessing its reliability in comparison with acquisitions at 3 T. Eight subjects were studied at 1 T and 3T using standard echo-planar-imaging sequences at 3-mm isotropic spatial resolution. Paradigms included silent word generation, sequential finger-to-thumb opposition, and passive finger movements. Image post-processing was carried out either with statistical parametric mapping (SPM5, single-subject and group analysis) or with a two-threshold correlation (TTC, single-subject analysis only) analysis. Single-subject analysis with SPM5 resulted in 3–5 times more activated pixels at 3 T than at 1 T in the examined Broca and sensorimotor regions. By comparison, the TTC single-subject analysis yielded the same amount of activated pixels at 3 T and 1 T. Moreover, this number was identical to that obtained with SPM at 3 T. The group analysis with SPM5 resulted in very similar numbers of activated pixels at both field strengths. The present findings suggest that a field strength of 1 T combined with adequate post-processing allows for reliable functional MRI studies of human brain activation. High-field advantages are therefore best invested in higher spatial resolution.     

Orthodontic springs and auxiliary appliances: assessment of magnetic field interactions associated with 1.5 T and 3 T magnetic resonance systems

The objective of this paper is to evaluate magnetic field interactions at 1.5 and 3 T for 20 orthodontic devices used for fixed orthodontic therapy. Twenty springs and auxiliary parts made from varying ferromagnetic alloys were tested for magnetic field interactions in the static magnetic field at 1.5 and 3 T. Magnetic translational force F_z (in millinewtons) was evaluated by determining the deflection angle β [American Society for Testing and Materials (ASTM standard test method)]. Magnetic-field-induced rotational force F_rot was qualitatively determined using a five-point scale. β was found to be >45° in 13(15) devices at 1.5(3) T and translational force F_z exceeded gravitational force F_g on the particular object [F_z 10.17–261.4 mN (10.72–566.4 mN) at 1.5(3) T]. F_z was found to be up to 24.1(47.5)-fold higher than F_g at 1.5(3) T. Corresponding to this, F_rot on the objects was shown to be high at both field strengths (≥ +3). Three objects (at 1.5 T) and one object (at 3 T) showed deflection angles <45°, but F_rot was found to be ≥ +3 at both field strengths. For the remaining objects, β was below 45° and torque measurements ranged from 0 to +2. Of 20 objects investigated for magnetic field interactions at 1.5(3) T, 13(15) were unsafe in magnetic resonance (MR), based on the ASTM criteria of F_z. The implications of these results for orthodontic patients undergoing MRI are discussed.     

Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer

The purpose of this study was to assess the diagnostic accuracy of whole-body MRI (WB-MRI) at 1.5 T or 3 T compared with FDG-PET-CT in the follow-up of patients suffering from colorectal cancer. In a retrospective study, 24 patients with a history of colorectal cancer and suspected tumour recurrence underwent FDG-PET-CT and WB-MRI with the use of parallel imaging (PAT) for follow-up. High resolution coronal T1w-TSE and STIR sequences at four body levels, HASTE imaging of the lungs, contrast-enhanced T1w- and T2w-TSE sequences of the liver, brain, abdomen and pelvis were performed, using WB-MRI at either 1.5 T (n = 14) or 3 T (n = 10). Presence of local recurrent tumour, lymph node involvement and distant metastatic disease was confirmed using radiological follow-up within at least 5 months as a standard of reference. Seventy seven malignant foci in 17 of 24 patients (71%) were detected with both WB-MRI and PET-CT. Both investigations concordantly revealed two local recurrent tumours. PET-CT detected significantly more lymph node metastases (sensitivity 93%, n = 27/29) than WB-MRI (sensitivity 63%, n = 18/29). PET-CT and WB-MRI achieved a similar sensitivity for the detection of organ metastases with 80% and 78%, respectively (37/46 and 36/46). WB-MRI detected brain metastases in one patient. One false-positive local tumour recurrence was indicated by PET-CT. Overall diagnostic accuracy for PET-CT was 91% (sensitivity 86%, specificity 96%) and 83% for WB-MRI (sensitivity 72%, specificity 93%), respectively. Examination time for WB-MRI at 1.5 T and 3 T was 52 min and 43 min, respectively; examination time for PET-CT was 103 min. Initial results suggest that differences in accuracy for local and distant metastases detection using FDG-PET-CT and WB-MRI for integrated screening of tumour recurrence in colorectal cancer depend on the location of the malignant focus. Our results show that nodal disease is better detected using PET-CT, whereas organ disease is depicted equally well by both investigations.     

Comparison of left ventricular function assessment using phonocardiogram- and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T

Objective

As high-field cardiac MRI (CMR) becomes more widespread the propensity of ECG to interference from electromagnetic fields (EMF) and to magneto-hydrodynamic (MHD) effects increases and with it the motivation for a CMR triggering alternative. This study explores the suitability of acoustic cardiac triggering (ACT) for left ventricular (LV) function assessment in healthy subjects (n?=?14).

Methods

Quantitative analysis of 2D CINE steady-state free precession (SSFP) images was conducted to compare ACT’s performance with vector ECG (VCG). Endocardial border sharpness (EBS) was examined paralleled by quantitative LV function assessment.

Results

Unlike VCG, ACT provided signal traces free of interference from EMF or MHD effects. In the case of correct R-wave recognition, VCG-triggered 2D CINE SSFP was immune to cardiac motion effects—even at 3.0 T. However, VCG-triggered 2D SSFP CINE imaging was prone to cardiac motion and EBS degradation if R-wave misregistration occurred. ACT-triggered acquisitions yielded LV parameters (end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and left ventricular mass (LVM)) comparable with those derived from VCG-triggered acquisitions (1.5 T: ESV_VCG?=?(56?±?17) ml, EDV_VCG?=?(151?±?32) ml, LVM_VCG?=?(97?±?27) g, SV_VCG?=?(94?±?19) ml, EF_VCG?=?(63?±?5)% cf. ESV_ACT?=?(56?±?18) ml, EDV_ACT?=?(147?±?36) ml, LVM_ACT?=?(102?±?29) g, SV_ACT?=?(91?±?22) ml, EF_ACT?=?(62?±?6)%; 3.0 T: ESV_VCG?=?(55?±?21) ml, EDV_VCG?=?(151?±?32) ml, LVM_VCG?=?(101?±?27) g, SV_VCG?=?(96?±?15) ml, EF_VCG?=?(65?±?7)% cf. ESV_ACT?=?(54?±?20) ml, EDV_ACT?=?(146?±?35) ml, LVM_ACT?=?(101?±?30) g, SV_ACT?=?(92?±?17) ml, EF_ACT?=?(64?±?6)%).

Conclusions

ACT’s intrinsic insensitivity to interference from electromagnetic fields renders it suitable for clinical CMR.     

MRI of the ankle joint in healthy non-athletes and in marathon runners: image quality issues at 7.0 T compared to 1.5 T

Objective

To present imaging characteristics of the ankle at 7.0 T and to investigate the appearance and image quality of presumed pathologies of ankles without physical strain as well as of ankles after a marathon run in comparison to 1.5 T.

Materials and methods

Appearance of presumed pathologic findings and image quality of TSE (PD, T2, and STIR) and GRE sequences (MEDIC, DESS, and/or CISS) at 7.0 T and 1.5 T MRI were compared by two senior radiologists in consensus in two healthy controls without strain and in six marathon runners after a full-length marathon (eight males, mean age 49.1 years).

Results

Overall, 7.0 T MRI allowed for higher resolution images for most of the sequences while requiring comparable acquisition times and achieving high contrast images mainly in gradient echo sequences. Bursal or presumed peritendineal fluid and/or edematous tissue, which were found in seven of eight subjects, could be best appreciated with 7.0 T MEDIC. Other findings with sharper delineation at 7.0 T included cartilage defects (best: CISS), osseous avulsions, and osteophytes (best: DESS). Nevertheless, 1.5 T STIR imaging enabled assessment of a tibiotalar bone edema-like lesion in two runners, which was barely visible at 7.0 T using STIR, but not with any other sequence at 7.0 T including MEDIC (with frequency selective fat suppression). 7.0 T showed larger image quality variations with challenges especially in the TSE sequences.

Conclusion

Our initial results of ultra-high-field ankle joint imaging demonstrate the improved depiction of ankle anatomy, fluid depositions, and cartilage defects. However imaging of edema-like bone lesions remains challenging at ultra-high magnetic field strength, and TSE coverage in particular is limited by the specific absorption rate.     

MRT des Sprunggelenks Vergleich eines Ganzkörper-Mittelfeldgeräts (1,0 T) mit einem dedizierten Niederfeldgerät (0,2 T)

PURPOSE: Comparison of ankle joint injuries with different MR systems and at different field strengths. METHOD: Ten patients with acute ankle injuries were examined using mid-field (1.0 T) and dedicated low-field (0.2 T) MR units. Findings of ligamentous injury, sinus tarsi involvement, bone injury, and tendon injury were correlated. RESULTS: There was no significant difference between mid- and low-field MR imaging for ligamentous injuries (chi 2 = 0.0395), sinus tarsi changes bone injuries (chi 2 = 0.0507; critical value = 5,991). CONCLUSION: This study showed good agreement in pathological findings in ankle injury on mid-field and low-field MR imaging.     

Bilateral ce-MR angiography of the hands at 3.0 T and 1.5 T: intraindividual comparison of quantitative and qualitative image parameters in healthy volunteers

The purpose of this study was to determine the benefit of bilateral contrast-enhanced MR angiography (ce-MRA) of the hands at 3.0 Tesla (T) compared with an established 1.5-T technique in healthy volunteers. Intraindividual bilateral ce-MRA of the hands was performed at 1.5 T and 3.0 T in 14 healthy volunteers using a timed ultra-fast GRE sequence featuring parallel acquisition. The evaluation comprised measurement of the vessel signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), rating of the image quality and the assessment of artefacts and venous contamination. At 3.0 T, SNR improved up to 95% and CNR up to 129%. The image quality of the larger inflow arteries, the palm arches and common digital arteries was good or sufficient at either magnetic field strengths. However, 3.0-T MRA was clearly superior in the depiction of the digital arteries. Ce-MRA of the hand clearly profits from the use of 3.0 T. Compared with 1.5 T, a substantial increase of CNR is found resulting in a significantly better delineation of the small digital arteries. Saturation affects more the SNR of the perivascular tissue than the contrast-enhanced blood, and thus leads to a marked increase of CNR at 3.0.     

High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent

Objective

Stress perfusion magnetic resonance imaging (MSPMRI) is an established technique for the assessment of myocardial perfusion. Shortcomings at 1.5 T are low signal to noise ratio (SNR) and contrast to noise ratio (CNR). One approach to overcome these shortcomings is to increase field strength and contrast concentration. The aim of our study was to investigate the diagnostic capability of high resolution MSPMRI at 3-T field strength using a 1 M contrast agent.

Material and methods

Fifty-seven patients (62.3?±?11.0 years) with symptoms of coronary artery disease (CAD) were examined at 3 T. MMRSPI was assessed using a 2D saturation recovery gradient echo (SR GRE) sequence in short axis orientation (TR 1.9 ms, TE 1.0 ms, flip 12°, 0.1 mmol gadobutrol/kg body weight (bw), 140 µg adenosine/kg bw/min). Perfusion images were assessed visually and semiquantitatively (upslope, peak signal intensity (SI), and myocardial perfusion reserve index (MPRI)). Standard of reference was invasive coronary angiography.

Results

Stress-induced hypoperfusion was found in 43 patients. Sensitivity for hemodynamically relevant CAD (stenoses greater than 70%) was 95%/98%, specificity 80%/87%, diagnostic accuracy 91%/95% (reader 1/reader 2). The MPRI was significantly lower in hypoperfused myocardium (1.3?±?0.2) compared with normal myocardium (2.6?±?0.7).

Conclusion

High resolution MMRSPI at 3 T using 1 M contrast agent under daily routine conditions provides reliable detection of stress-induced myocardial hypoperfusion with higher diagnostic accuracy than 1.5-T conditions.     

MR imaging of the human hand and wrist at 7 T

Objective  The purpose of this study was to evaluate the feasibility, quality, and possible future implications of magnetic resonance imaging (MRI) of the human hand and wrist at 7 T. Materials and methods  Images of the left hand of a healthy volunteer were acquired with a 7- and a 1.5-T whole body system and comparatively analyzed. Axial and coronal two-dimensional gradient echo (GRE) images with inflow saturation, coronal 3D GRE images, and time-of-flight angiographies were obtained without averaging. Image details were related to the complex hand anatomy. Results  With the 7-T protocols established in this study, high-quality and high-resolution images of the hand and wrist were obtained. In the 2D GRE images at 7 T, small anatomical structures of the hand were depicted in vivo with superior detail and resolution, compared to 1.5 T and published studies at lower field strength. Signal-to-noise ratios (SNRs) were approximately five times higher at 7 T compared to 1.5 T. Additionally, thin 3D GRE images with good quality of the whole hand were obtained in a short acquisition time. Moreover, time-of-flight angiographies of the small hand arteries have been acquired without the application of contrast agents. Conclusion  Seven-tesla imaging of the hand can be used in vivo with ultra-high resolution and sufficient SNR. It allows for exact delineation of most anatomical structures including nerves, muscles, tendons, ligaments, cartilage, and blood vessels.     

Proton MR spectroscopy of the brain at 3 T: an update

Proton magnetic resonance spectroscopy (¹H-MRS) provides specific metabolic information not otherwise observable by any other imaging method. ¹H-MRS of the brain at 3 T is a new tool in the modern neuroradiological armamentarium whose main advantages, with respect to the well-established and technologically advanced 1.5-T ¹H-MRS, include a higher signal-to-noise ratio, with a consequent increase in spatial and temporal resolutions, and better spectral resolution. These advantages allow the acquisition of higher quality and more easily quantifiable spectra in smaller voxels and/or in shorter times, and increase the sensitivity in metabolite detection. However, these advantages may be hampered by intrinsic field-dependent technical issues, such as decreased T₂ signal, chemical shift dispersion errors, J-modulation anomalies, increased magnetic susceptibility, eddy current artifacts, challenges in designing and obtaining appropriate radiofrequency coils, magnetic field instability and safety hazards. All these limitations have been tackled by manufacturers and researchers and have received one or more solutions. Furthermore, advanced ¹H-MRS techniques, such as specific spectral editing, fast ¹H-MRS imaging and diffusion tensor ¹H-MRS imaging, have been successfully implemented at 3 T. However, easier and more robust implementations of these techniques are still needed before they can become more widely used and undertake most of the clinical and research ¹H-MRS applications.     

Magnetic resonance imaging protocols for examination of the neurocranium at 3 T

The increasing availability of high-field (3 T) MR scanners requires adapting and optimizing clinical imaging protocols to exploit the theoretically higher signal-to-noise ratio (SNR) of the higher field strength. Our aim was to establish reliable and stable protocols meeting the clinical demands for imaging the neurocranium at 3 T. Two hundred patients with a broad range of indications received an examination of the neurocranium with an appropriate assortment of imaging techniques at 3 T. Several imaging parameters were optimized. Keeping scan times comparable to those at 1.5 T we increased spatial resolution. Contrast-enhanced and non-enhanced T1-weighted imaging was best applying gradient-echo and inversion recovery (rather than spin-echo) techniques, respectively. For fluid-attenuated inversion recovery (FLAIR) imaging a TE of 120 ms yielded optimum contrast-to-noise ratio (CNR). High-resolution isotropic 3D data sets were acquired within reasonable scan times. Some artifacts were pronounced, but generally imaging profited from the higher SNR. We present a set of optimized examination protocols for neuroimaging at 3 T, which proved to be reliable in a clinical routine setting.     

Human subthalamic nucleus: evaluation with high-resolution MR imaging at 3.0 T

INTRODUCTION: The purpose of this study was to compare the visibility of the normal subthalamic nucleus (STN) between fast spin-echo T2-weighted (FSE T2-W) images and fast short inversion time inversion-recovery (FSTIR) images, and to assess the age-related changes of the STN at 3.0 T. METHODS: We evaluated high-resolution FSE T2-W and FSTIR images in 24 neurologically normal subjects. Using both sequences, we assessed the visibility of the margins of the STN, and calculated the difference in signal intensity between the STN and structures adjacent to the STN. Then, to assess the age-related changes of the STN, we calculated the contrast-to-noise ratio between the STN and the white matter, and measured the position, length, and height of the STN. All data were statistically evaluated. RESULTS: The visibility of the lower margin of the STN was significantly better on the FSTIR images than on the FSE T2-W images (P = 0.0001), while the visibility of other margins was significantly better on the FSE T2-W images than on the FSTIR mages (P = 0.002). The difference in signal intensity between the STN and substantia nigra was significantly greater on the FSTIR images than on the FSE T2-W images (P < 0.0001). The distance from the midline to the lateral border of the STN increased with age (FSE T2-W images: left r = 0.4916, P = 0.015; right r = 0.4442, P = 0.030). CONCLUSION: The combined reading of both FSE T2-W and FSTIR images at 3 T will improve the identification of the STN. The age-related positional change of the STN should be considered in target determination for deep brain stimulation procedures.     

Branching pattern of lenticulostriate arteries observed by MR angiography at 3.0 T

Purpose  

We hypothesized that the pattern of branching of the lenticulostriate arteries (LSAs) is involved in the variation of the distribution of the infarction within the LSA region. Our purpose was to evaluate the visibility of LSAs in 3D time-of-flight (TOF) MR angiography (MRA) with a 3.0 T scanner and to investigate the branching patterns of LSAs.     

Lactate and T 2 measurements of synovial aspirates at 1.5 T: differentiation of septic from non-septic arthritis

OBJECTIVE: The aim of this study was to differentiate septic from non-septic arthritis by measuring lactate concentration with (1)H magnetic resonance spectroscopy (HMRS) and by estimating total protein content with the assessment of T (2) values. MATERIALS AND METHODS: In 30 patients with acute arthritis, synovial fluid was aspirated. Lactate concentrations were analyzed with single voxel HMRS at 1.5 T. T (2) relaxation times were mapped with a multi-spin echo sequence. All samples underwent microbiological testing and routine laboratory analysis to quantify lactate concentration and total protein content. Values obtained in septic and non-septic arthritis were compared with a Mann-Whitney U test. RESULTS: Synovial fluid from patients with septic arthritis (n = 10) had higher concentrations of lactate (11.4 +/- 4.0 mmol/L) and higher total protein content (51.8 +/- 10.7 g/L) than fluid obtained in non-septic arthritis (n = 20; 5.2 +/- 1.1 mmol/L and 40.4 +/- 6.9 g/L, respectively, p < 0.001 and <0.01, respectively). Measured lactate concentrations and T (2) relaxation times (as an indicator of total protein content) were moderately correlated to laboratory-confirmed lactate concentration (r (2) = 0.71) and total protein content (r (2) = 0.73). Markedly increased lactate concentrations (>6 mmol/L) in combination with low T (2) values (<550 ms) identify septic arthritis with a sensitivity of 70% and a specificity of 89%. CONCLUSION: Spectroscopic measurements of lactate concentration in combination with the estimation of protein content using T (2) may be of value in the differentiation of septic from non-septic arthritis.     

Cerebral vein changes in relapsing-remitting multiple sclerosis demonstrated by three-dimensional enhanced T 2 * -weighted angiography at 3.0 T

Objective

To investigate characteristics of the internal cerebral veins (ICVs) and their main tributaries and the deep medullary veins (DMVs) in patients with relapsing-remitting MS (RRMS) with enhanced T ₂ ^* -weighted angiography imaging (ESWAN).

Methods

Fifty-three RRMS patients and 53 normal controls underwent conventional MRI and ESWAN. ESWAN venograms were created by performing minimum intensity projections of the phase images, and the resulting venograms were used to observe characteristic vascular changes, including scores of the ICVs and their main tributaries and manifestations of the DMVs. Two experienced radiologists analysed all data.

Results

Patients showed decreased mean scores of the ICVs and their main tributaries compared with controls. The mean score in acute patients was higher than in stable patients. Furthermore, the DMVs diminished and shortened in 48 patients with longer disease duration, whereas the DMVs increased and elongated in 5 patients with shorter disease duration. The penetrating veins were well defined in 30 active lesions, whereas the veins were ill defined in 69 non-active lesions. Interestingly, well-defined penetrating veins were shown in 15 non-active lesions in the stable patients.

Conclusions

Enhanced T ₂ ^* -weighted MR angiography can detect cerebral vein characteristics in relapsing-remitting MS patients, which may provide important information on the pathogenesis of MS.

Key Points

? Enhanced T ₂ ^* -weighted magnetic resonance angiography (ESWAN) provides new insights into multiple sclerosis ? ESWAN venograms clearly demonstrate the internal cerebral and deep medullary veins ? The internal cerebral veins exhibit abnormalities in patients with relapsing-remitting MS ? Deep medullary veins exhibit different manifestations in patients with different disease duration