Comparison between contrast-enhanced fat-suppressed 3D FLAIR brain MR images and T2-weighted orbital MR images at 3 Tesla for the diagnosis of acute optic neuritis.

IF 4.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Diagnostic and Interventional Imaging Pub Date : 2024-09-05 DOI:10.1016/j.diii.2024.08.001

Sharmiladevi Manasse, Patricia Koskas, Julien Savatovsky, Romain Deschamps, Catherine Vignal-Clermont, Marine Boudot de la Motte, Caroline Papeix, Stéphanie Trunet, Augustin Lecler

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Abstract

Purpose: The purpose of this study was to compare the capabilities of contrast-enhanced fat-suppressed (CE FS) three-dimensional fluid-attenuated inversion recovery (3D FLAIR) brain magnetic resonance imaging (MRI) with those of coronal T2-weighted orbital MRI obtained at 3 Tesla for the diagnosis of optic neuritis (ON).

Materials and methods: Patients who presented to our center with acute visual loss and underwent MRI examination of the orbits and the brain between November 2014 and February 2020 were retrospectively included. Three radiologists independently and blindly analyzed CE FS 3D FLAIR and coronal T2-weighted images. Disagreements in image interpretation were resolved by consensus with an independent neuroradiologist who was not involved in the initial reading sessions. The primary adjudication criterion for the diagnosis of ON was the presence of an optic nerve hypersignal. Sensitivity, specificity, and accuracy of CE 3D FLAIR brain images were compared with those of coronal T2-weighted orbital images using McNemar test. Artifacts were classified into three categories and compared between the two image sets.

Results: A total of 1023 patients were included. There were 638 women and 385 men with a mean age of 42 ± 18.3 (standard deviation) years (age range: 6-92 years). Optic nerve hyperintensities were identified in 375/400 (94%) patients with ON using both 3D FLAIR and coronal T2-weighted images. Sensitivity, specificity, and accuracy of both sequences were 94% (95% CI: 91.3-96.1), 79% (95% CI: 75.5-82.2), and 89% (95% CI: 86.8-90.7), respectively. Optic disc hypersignal was detected in 120/400 patients (30%) using 3D FLAIR compared to 3/400 (0.75%) using coronal T2-weighted images (P < 0.001). Optic radiation hypersignal was observed in 2/400 (0.5%) patients using 3D FLAIR images. Significantly more artifacts (moderate or severe) were observed on coronal T2-weighted images (801/1023; 78%) by comparison with 3D FLAIR images (448/1023; 44%) (P < 0.001).

Conclusion: The performance of 3D FLAIR brain MRI for the diagnosis of ON is not different from that of coronal T2-weighted orbital MRI and its use for optic nerve analysis may be beneficial.

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对比增强脂肪抑制三维 FLAIR 脑磁共振图像和 3 特斯拉 T2 加权眼眶磁共振图像诊断急性视神经炎的效果。

目的：本研究旨在比较对比增强脂肪抑制（CE FS）三维流体增强反转恢复（3D FLAIR）脑磁共振成像（MRI）与3特斯拉冠状T2加权眼眶MRI诊断视神经炎（ON）的能力：回顾性纳入2014年11月至2020年2月期间因急性视力丧失到我中心就诊并接受眼眶和脑部核磁共振成像检查的患者。三位放射科医生独立、盲法分析 CE FS 3D FLAIR 和冠状 T2 加权图像。图像判读中出现的分歧由一名未参与初步判读的独立神经放射科医生通过协商一致的方式解决。诊断ON的主要判定标准是是否存在视神经超信号。使用 McNemar 检验比较了 CE 3D FLAIR 脑图像与冠状 T2 加权眼眶图像的敏感性、特异性和准确性。伪影分为三类，并在两套图像之间进行比较：结果：共纳入 1023 名患者。结果：共纳入 1023 名患者，其中女性 638 名，男性 385 名，平均年龄为 42 ± 18.3（标准差）岁（年龄范围：6-92 岁）。通过三维 FLAIR 和冠状 T2 加权图像，375/400（94%）名 ON 患者的视神经高密度得以确定。两种序列的敏感性、特异性和准确性分别为 94% (95% CI: 91.3-96.1)、79% (95% CI: 75.5-82.2) 和 89% (95% CI: 86.8-90.7)。在使用三维 FLAIR 的 120/400 例患者（30%）中检测到视盘高信号，而使用冠状 T2 加权图像的 3/400 例患者（0.75%）中检测到视盘高信号（P < 0.001）。使用三维 FLAIR 图像的患者中，2/400（0.5%）观察到视神经辐射超信号。与三维 FLAIR 图像（448/1023；44%）相比，冠状 T2 加权图像（801/1023；78%）上观察到的伪影（中度或重度）明显增多（P < 0.001）：结论：三维 FLAIR 脑磁共振成像诊断 ON 的效果与冠状位 T2 加权眼眶磁共振成像诊断 ON 的效果无异，将其用于视神经分析可能有益。

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来源期刊

Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

8.50

自引率

29.10%

发文量

126

审稿时长

11 days

期刊介绍： Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.