Diagnostic value of gadolinium contrast administration for spinal cord magnetic resonance imaging in multiple sclerosis patients and correlative markers of lesion enhancement.

Abstract

Background:

Magnetic resonance imaging is essential for monitoring people with multiple sclerosis, but the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging is unclear.

Objective:

To assess the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging follow-up examinations and identify imaging markers correlating with lesion enhancement.

Methods:

A total of 65 multiple sclerosis patients with at least 2 spinal magnetic resonance imaging follow-up examinations were included. Spine magnetic resonance imaging was performed at 3 Tesla with a standardized protocol (sagittal and axial T2-weighted turbo spin echo and T1-weighted post-contrast sequences). T2 lesion load and enhancing lesions were assessed by two independent neuroradiologists for lesion size, localization, and T2 signal ratio (T2 signallesion/T2 signalnormal appearing spinal cord).

Results:

A total of 68 new spinal T2 lesions and 20 new contrast-enhancing lesions developed during follow-up. All enhancing lesions had a discernable correlate as a new T2 lesion. Lesion enhancement correlated with a higher T2 signal ratio compared to non-enhancing lesions (T2 signal ratio: 2.0 ± 0.4 vs. 1.4 ± 0.2, ****p < 0.001). Receiver operating characteristics analysis showed an optimal cutoff value of signal ratio 1.78 to predict lesion enhancement (82% sensitivity and 97% specificity).

Conclusion:

Gadolinium contrast administration is dispensable in follow-up spine magnetic resonance imaging if no new T2 lesions are present. Probability of enhancement correlates with the T2 signal ratio.

• Authors: Kianush Karimian-Jazi, Ulf Neuberger, Katharina Schregel, Gianluca Brugnara, Daniel Schwarz, Laura Bettina Jäger, Wolfgang Wick, Martin Bendszus, Michael O Breckwoldt
• Journal: Multiple sclerosis journal - experimental, translational and clinical (Mult Scler J Exp Transl Clin) Vol. 7 Issue 4 Pg. 20552173211047978 (Oct 2021) ISSN: 2055-2173 [Print] United States
• PMID: 34868625 (Publication Type: Journal Article)
• Copyright: © The Author(s), 2021.