Comparison of Phase Sensitive Inversion Recovery MRI with T2W-TSE and STIR in the Detection of Cervical Multiple Sclerosis Lesions

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that causes demyelination or loss of myelin in the white and gray matter of the brain and spinal cord.

In the current study, the phase sensitive inversion recovery (PSIR) sequence was compared with the other sequences (T2-weighted (T2W), short tau inversion recovery (STIR)) to represent the number and conspicuity of the lesions.

In this study, 35 MS patients were referred to the imaging center for MRI of the cervical spine. In the sagittal view, T2 weighted turbo spin echo (T2TSE), STIR, and PSIR and in the axial view, T2 TSE, and PSIR sequences were compared. The sequences were compared regarding the number of lesions and conspicuity. P value < 0.05 was considered statistically significant.

In sagittal view MRIs, mean plaque number in T2TSE, STIR and PSIR were 1.7 ± 1.1, 3.5 ± 1.4, and 3.4 ± 1.4, respectively (P < 0.001; PSIR and STIR were greater than T2TSE but their difference was not statistically significant). Regarding comparison of imaging conspicuity, most of the plaques in PSIR showed good resolution (75%). In fact, the highest conspicuity of plaques was detected in PSIR (P < 0.001). In axial view MRIs, comparing mean plaque count and conspicuity of lesions, PSIR showed better results than T2TSE (P < 0.001).

PSIR sequence showed high sensitivity and precision in the detection of plaques in the cervical spine. PSIR sequence is efficient as a complementary sequence in evaluating the cervical lesions of MS patients. It could increase the diagnostic accuracy in these patients.