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Research ArticleAdult Brain

How Common Is Signal-Intensity Increase in Optic Nerve Segments on 3D Double Inversion Recovery Sequences in Visually Asymptomatic Patients with Multiple Sclerosis?

T. Sartoretti, E. Sartoretti, S. Rauch, C. Binkert, M. Wyss, D. Czell and S. Sartoretti-Schefer
American Journal of Neuroradiology September 2017, 38 (9) 1748-1753; DOI: https://doi.org/10.3174/ajnr.A5262
T. Sartoretti
aFrom the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
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  • ORCID record for T. Sartoretti
E. Sartoretti
aFrom the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
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S. Rauch
aFrom the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
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C. Binkert
aFrom the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
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M. Wyss
aFrom the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
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D. Czell
bKlinik für Innere Medizin (D.C.), Abteilung für Neurologie, Kantonsspital Winterthur, Winterthur, Switzerland.
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S. Sartoretti-Schefer
aFrom the Institut für Radiologie (T.S., E.S., S.R., C.B., M.W., S.S.-S.)
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Article Figures & Data

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  • Fig 1.
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    Fig 1.

    On 3D DIR, bilaterally normal hypointense retrobulbar (A), canalicular (B), and prechiasmatic (C) optic nerve segments and a normal hypointense chiasm (D). The normal nerve segments are marked with white arrows. The normal hypointense retrobulbar optic nerve is surrounded by an isointense nerve sheath on 3D DIR (A).

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    Fig 2.

    Hyperintense susceptibility artifacts (white arrowheads) at the air-bone interface next to the canalicular nerve segments (A) and next to the prechiasmatic nerve segments (B). Optic nerve segments are marked with white arrows.

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    Fig 3.

    On 3D DIR, bilateral normal hypointense retrobulbar nerve segments (A) are compared with bilateral pathologic hyperintense retrobulbar nerve segments (B), with a unilateral pathologic hyperintense retrobulbar nerve segment on the left side (C) and a unilateral pathologic hyperintense canalicular nerve segment on the right side (D) in 3 different asymptomatic patients with MS. The hyperintense optic nerve segments are marked with white arrows. The normal hypointense optic nerve segments are marked with white arrowheads.

Tables

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    Table 1:

    Imaging parameters of the 3D DIR sequence

    Double Inversion Recovery
    Acquisition mode3D TSE
    Acquisition planeSagittal
    CoverageWhole head
    Reconstructions, section thickness (mm)Coronal, 2
    TR/TE (ms)5500/246
    TI (ms)2550/450
    FOV (mm)250 × 250 × 195
    Matrix240 × 240 × 310
    Acquired voxel size (mm)1.2 × 1.2 × 0.65
    No. of sections300
    Fat suppressionSPIR
    NEX2
    Acquisition time6 min 19 sec
    • Note:—SPIR indicates spectral presaturation with inversion recovery.

    • View popup
    Table 2:

    κ values and their confidence intervals for 3D DIR, based on nerve segments in the group of patients with MS

    3D DIR (No. of Valid Cases)Symmetric Measures
    Value MoA (κ)Asymp. SEaApprox. TbApprox. Sig.Exact Sig.95% CI
    Retrobulbar (190).942.02315.091.000.0000.896–0.987
    Canalicular (190)1.000.00015.891.000.0001.000–1.000
    Prechiasmatic (190).704.06513.886.000.0000.576–0.832
    Chiasm (95).918.08110.084.000.0000.759–1.077
    • Note:—MoA indicates measure of agreement; asymp. SE, asymptomatic standard error; approx., approximative; sig., significance.

    • ↵a Not assuming the null hypothesis.

    • ↵b Using the asymptomatic SE assuming the null hypothesis.

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    Table 3:

    κ values and their confidence intervals for 3D DIR, in the group of patients with MS in all 665 nerve segments combined

    3D DIRSymmetric Measures
    Value MoA (κ)Asymp. SEaApprox. TbApprox. Sig.Exact Sig.95% CI
    665 Valid cases (all nerve segments).931.01529.761.000.0000.901–0.961
    • Note:—MoA indicates measure of agreement; asymp. SE, asymptomatic standard error; approx., approximative; sig., significance.

    • ↵a Not assuming the null hypothesis.

    • ↵b Using the asymptotic SE assuming the null hypothesis.

    • View popup
    Table 4:

    Signal intensity of optic nerve segments evaluated on 3D DIR in patients with MS

    Optic Nerve Segment (No. of Nerves Evaluated)Signal Intensity on 3D DIR Compared with Signal Intensity of the Lateral Rectus Muscle (%)
    HypointenseIsointenseHyperintenseIsointense or Hyperintense
    Retrobulbar (190)108 (57%)87482 (43%)
    Canalicular (190)129 (68%)95261 (32%)
    Prechiasmatic (190)178 (93.5%)9413 (6.5%)
    Chiasm (95)89 (93.5%)516 (6.5%)
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American Journal of Neuroradiology: 38 (9)
American Journal of Neuroradiology
Vol. 38, Issue 9
1 Sep 2017
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Cite this article
T. Sartoretti, E. Sartoretti, S. Rauch, C. Binkert, M. Wyss, D. Czell, S. Sartoretti-Schefer
How Common Is Signal-Intensity Increase in Optic Nerve Segments on 3D Double Inversion Recovery Sequences in Visually Asymptomatic Patients with Multiple Sclerosis?
American Journal of Neuroradiology Sep 2017, 38 (9) 1748-1753; DOI: 10.3174/ajnr.A5262

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How Common Is Signal-Intensity Increase in Optic Nerve Segments on 3D Double Inversion Recovery Sequences in Visually Asymptomatic Patients with Multiple Sclerosis?
T. Sartoretti, E. Sartoretti, S. Rauch, C. Binkert, M. Wyss, D. Czell, S. Sartoretti-Schefer
American Journal of Neuroradiology Sep 2017, 38 (9) 1748-1753; DOI: 10.3174/ajnr.A5262
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