• F X Aymerich, C Auger, P Alcaide-Leon, D Pareto, E Huerga, J F Corral, R Mitjana, J Sastre-Garriga, X Montalban, and A Rovira.
• MR Unit. Department of Radiology (IDI), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, P. Vall d'Hebron 119-129, 08035, Barcelona, Spain. xavier.aymerich@idi.gencat.cat.
• Eur Radiol. 2017 Apr 1; 27 (4): 1361-1368.

ObjectivesTo compare the sensitivity of enhancing multiple sclerosis (MS) lesions in gadolinium-enhanced 2D T1-weighted gradient-echo (GRE) and spin-echo (SE) sequences, and to assess the influence of visual conspicuity and laterality on detection of these lesions.MethodsOne hundred MS patients underwent 3.0T brain MRI including gadolinium-enhanced 2D T1-weighted GRE and SE sequences. The two sets of contrast-enhanced scans were evaluated in random fashion by three experienced readers. Lesion conspicuity was assessed by the image contrast ratio (CR) and contrast-to-noise ratio (CNR). The intracranial region was divided into four quadrants and the impact of lesion location on detection was assessed in each slice.ResultsSix hundred and seven gadolinium-enhancing MS lesions were identified. GRE images were more sensitive for lesion detection (0.828) than SE images (0.767). Lesions showed a higher CR in SE than in GRE images, whereas the CNR was higher in GRE than SE. Most misclassifications occurred in the right posterior quadrant.ConclusionsThe gadolinium-enhanced 2D T1-weighted GRE sequence at 3.0T MRI enables detection of enhancing MS lesions with higher sensitivity and better lesion conspicuity than 2D T1-weighted SE. Hence, we propose the use of gadolinium-enhanced GRE sequences rather than SE sequences for routine scanning of MS patients at 3.0T.Key Points• 2D SE and GRE sequences are useful for detecting active MS lesions. • Which of these sequences is more sensitive at high field remains uncertain. • GRE sequence showed better sensitivity for detecting active MS lesions than SE. • We propose GRE sequence for detecting active MS lesions at 3.0T.

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