SWI as an Alternative to Contrast-Enhanced Imaging to Detect Acute MS Lesions

Acute inflammatory activity of MS lesions is traditionally assessed through contrast-enhanced T1-weighted MR images. The aim of our study was to determine whether a qualitative evaluation of non-contrast-enhanced SWI of new T2-hyperintense lesions might help distinguish acute and chronic lesions and...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2022-04, Vol.43 (4), p.534-539
Main Authors: Caruana, G, Auger, C, Pessini, L M, Calderon, W, de Barros, A, Salerno, A, Sastre-Garriga, J, Montalban, X, Rovira, À
Format: Article
Language:English
Subjects:
Adult Brain
Contrast Media
Functional
Gadolinium
Gadolinium DTPA
Humans
Magnetic Resonance Imaging - methods
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Summary:Acute inflammatory activity of MS lesions is traditionally assessed through contrast-enhanced T1-weighted MR images. The aim of our study was to determine whether a qualitative evaluation of non-contrast-enhanced SWI of new T2-hyperintense lesions might help distinguish acute and chronic lesions and whether it could be considered a possible alternative to gadolinium-based contrast agents for this purpose. Serial MR imaging studies from 55 patients with MS were reviewed to identify 169 new T2-hyperintense lesions. Two blinded neuroradiologists determined their signal pattern on SWI, considering 5 categories (hypointense rings, marked hypointensity, mild hypointensity, iso-/hyperintensity, indeterminate). Two different blinded neuroradiologists evaluated the presence or absence of enhancement in postcontrast T1-weighted images of the lesions. The Fisher exact test was used to determine whether each category of signal intensity on SWI was associated with gadolinium enhancement. The presence of hypointense rings or marked hypointensity showed a strong association with the absence of gadolinium enhancement (
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A7474