Abstract Details

Title Contrast enhancement sources on post-Gadolinium “black-blood” 3D T1-weighted Turbo-Spin-Echo images in patients with multiple sclerosis.

Topic Multiple Sclerosis

Presentation(s) P15 - Poster Session 15 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-001

Background

3D turbo-spin-echo (TSE) T1-weighted techniques provide superior sensitivity to enhancing MS lesions in the brain and minimize vessel enhancement confound. However, misdiagnosis cases linked to small iV were reported.

Objective

To test the hypothesis that brain intraparenchymal veins (iV) enhancement on post-Gadolinium “black-blood” 3D-T1-TSE magnetic resonance images may confound the diagnosis of active lesions in multiple sclerosis (MS) patients.

Design/Methods Post-Gadolinium “black-blood” 3D-T1-TSE (“SPACE”) images were obtained at 3T from 232 patients with MS, CIS or RIS, and compared with classical “MPRAGE” and “VIBE” images. iV contrast-to-noise ratio (CNR) was estimated at the level of the thalami. Two expert and one beginner readers blindly detected enhancing lesions. True positive (TP) and FP were determined by senior readers’ consensus. Differences in TP and FP frequency and patient-level diagnosis probability, were tested with McNemar’s and Odds Ratio (OR). CNR and morphology compared with Mann-Whitney-U and χ²tests, respectively.

Results

iV CNR was higher with SPACE than MPRAGE and VIBE (P<0.001, both). There were 66 TP and 74 FP considering all sequences. SPACE detected more TP and FP (P range <0.001-0.07), but did not increase patient’s TP likelihood (OR=1-1.29, P=0.478-1). However, FP likelihood was increased (OR=3.03-3.55, P=0.008-0.027). Venous-origin FP (N=59) occurred more frequently with SPACE (P<0.001) and exhibited overlapping CNR and morphology with TP when small-sized (≤14mm³, P=0.544).

Conclusions

Small iV may confound enhancing MS lesion diagnosis on post-Gadolinium “black-blood” 3D-T1-TSE images.

Authors/Disclosures
Claudio Gobbi, MD (Ospedale Regionale Lugano) PRESENTER	The institution of Dr. Gobbi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie, Almirall, Biogen Idec, Celgene, Sanofi, Merck, Novartis, Teva Pharma, Roche.. Dr. Gobbi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie, Almirall, Biogen Idec, Celgene, Sanofi, Merck, Novartis, Teva Pharma, Roche..
	No disclosure on file
	No disclosure on file
	No disclosure on file
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Chiara C. Zecca, MD (Ente ospedaliero cantonale)	The institution of Dr. Zecca has received research support from Ente Ospedaliero Cantonale.