Magnetic Resonance in Medical Sciences
Online ISSN : 1880-2206
Print ISSN : 1347-3182
ISSN-L : 1347-3182
Major Papers
Juxtacortical Lesions in Multiple Sclerosis: Assessment of Gray Matter Involvement Using Phase Difference-enhanced Imaging (PADRE)
Koichiro FUTATSUYA, Shingo KAKEDA, Tetsuya YONEDA, Issei UEDA, Keita WATANABE, Junji MORIYA, Yu MURAKAMI, Satoru IDE, Atsushi OGASAWARA, Norihiro OHNARI, Kazumasa OKADA, Hiroaki ADACHI, Yukunori KOROGI
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Keywords: multiple sclerosis, phase difference enhanced imaging, juxtacortical lesion, gray matter involvement
JOURNAL OPEN ACCESS

2016 Volume 15 Issue 4 Pages 349-354

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Abstract

Purpose: In multiple sclerosis (MS), a juxtacortical lesion at the border between the gray matter (GM) and subcortical white matter (WM) may often involve the GM. A recently developed, phase-weighted magnetic resonance imaging (MRI) technique “phase difference enhanced imaging (PADRE)” can delineate the GM and WM clearly due to the difference in myelin concentration. We evaluated whether PADRE is useful for the detection of GM involvement in the juxtacortical MS lesions.
Methods: One neuroradiologist reviewed the conventional MRI in 13 MS patients and selected 48 juxtacortical lesions. At the first reading session with the conventional MRI alone (T2-weighted imaging, and two-dimensional and three-dimensional fluid-attenuated inversion recovery), two other neuroradiologists classified the lesions into three patterns according to their anatomical locations: (a) subcortical WM lesions involving the subcortical WM alone; (b) intracortical (IC) lesions involving the GM alone; (c) mixed GM/subcortical WM (mixed) lesions involving the both subcortical WM and GM. We defined the subcortical WM as a WM within a distance of 10 mm from inner edge of the GM. For the analyses, we excluded the white matter lesions further than 10 mm from inner edge of the GM. At the second reading session MRI and PADRE were available and the radiologists re-evaluated their prior classification.
Results: At the first reading session, 27 lesions were classified as (a), 1 as (b), and 20 as (c). Therefore, a total of 21 lesions (44%) were judged to involve the GM. At the second reading session, the classification of 15 (31%) lesions changed; all 15 lesions were judged to involve the GM on the PADRE. Interobserver agreement (kappa value) was 0.84 for the first- and 0.95 for the second reading session.
Conclusion: PADRE is useful for detecting GM involvement of the juxtacortical MS lesions.

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© 2016 by Japanese Society for Magnetic Resonance in Medicine

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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