Article Figures & Data
Figures
- Fig 1.
Measurement of lesion edge sharpness on a sagittal WMS image in a 39-year-old woman with a relapsing-remitting subtype of multiple sclerosis. A line is drawn along the long axis of the lesion located at the C2–C3 level, which includes the adjoining normal-appearing cord. The histogram derived represents the signal-intensity profile along the line. Lesion edge sharpness is determined by the average of distance required for a 20%–80% change in the signal intensity at the upper and lower margins of the lesion.
- Fig 2.
Example of improved lesion conspicuity in a 45-year-old woman with a relapsing-remitting subtype of multiple sclerosis. Sagittal STIR (A) and PDWTSE (B) images show a focal lesion in the dorsum of the cord at the lower C2 level (arrow). Anterior to this lesion, there is linear hyperintensity in the center of the cord usually noted on the STIR/PDWTSE sequence group (arrowhead). The central canal is more homogeneous in signal intensity on sagittal WMS image (C); this feature improves the definition of the superior margin of the dorsal lesion. An additional focal lesion is noted in the ventral cord at the upper C2 level (open arrow), better identified on the WMS sequence (C).
- Fig 3.
An example of a definite lesion missed on STIR/PDWTSE in a 40-year-old woman with multiple sclerosis. Sagittal STIR (A) and PDWTSE (B) images show focal lesions at the C3 and C6 levels (arrowheads). Another lesion at the C2 level (arrow) is less conspicuous due to central cord high signal in STIR/PDWTSE. On WMS (C), the lesion at C2 is better visualized. An additional focal lesion is noted on WMS at the C4 level (open arrow), which is identified on PDWTSE as a faint hyperintensity on the side-by-side comparison.
Tables
Independent Analysis STIR/PDWTSE WMS TL, MPL (SD) Interreader Agreement (κ) TL, MPL (SD) Interreader Agreement (κ) Total lesion count in 42 patients Reader 1 177, 4.2 (3.0) 191, 4.5 (3.5) Reader 2 183, 4.3 (3.4) 189, 4.5 (3.5) C1–C4 lesion count Reader 1 101, 2.4 (1.6) 0.49 104, 2.5 (1.9) 0.82 Reader 2 108, 2.6 (2.0) 104, 2.5 (2.0) C5–C7 lesion count Reader 1 76, 1.8 (1.7) 0.52 87, 2.1 (1.9) 0.84 Reader 2 79, 1.9 (1.8) 85, 2.0 (1.8) Note:—TL indicates total lesion count; MPL, mean lesions per patient.
STIR/PDWTSE WMS P Value Independent analysis Overall subjective lesion conspicuity, C1–C4 (M1,2, M1, M2) 3.1, 3.1, 3.0 3.7, 3.8, 3.7 <.01 Overall subjective lesion conspicuity, C5–C7 (M1,2, M1, M2) 3.1, 3.2, 3.0 3.8, 4.1, 3.5 <.01 Side-by-side analysis Spurious discrepant lesions Reader 1 (DL, MDL) 23, 0.5 3, 0.1 <.01 Reader 2 (DL, MDL) 30, 0.7 4, 0.1 <.01 True missed discrepant lesions Reader 1 (DL, MDL) 37, 0.9 3, 0.1 <.01 Reader 2 (DL, MDL) 38, 0.9 6, 0.1 <.01 Note:—M1, 2 indicates mean lesions per level for reviewers 1 and 2; M1, mean lesions per level for reviewer 1; M2, mean lesions per level for reviewer 2; DL, total discrepant lesion; MDL, average mean discrepant lesion.
STIR (Mean) (SD) PDWTSE (Mean) (SD) WMS (Mean) (SD) P Value STIR vs PDWTSE STIR vs WMS PDWTSE vs WMS Contrast ratio (n = 82) 0.4 (0.2) 0.2 (0.2) 0.8 (0.5) <.01 <.01 <.01 LES in mm (n = 25) 3.1 (0.9) 2.9 (0.5) 2.3 (0.6) .11 <.01 <.01
