Improved identification of multiple sclerosis brain lesions with three-dimensional double inversion recovery MRI

Abstract

Background Multiple sclerosis (MS) is a chronic autoimmune disease that results in demyelination within the central nervous system, causing brain lesions and neurological dysfunction. Precise identification of these lesions is essential for proper diagnosis and management. Aim This study aims to assess the effectiveness of three-dimensional double inversion recovery (3D DIR) MRI in detecting MS brain lesions compared to two-dimensional fluid-attenuated inversion recovery (2D FLAIR) and T2-weighted imaging (T2WI). Patients and methods A cross-sectional study involving 49 MS patients (21 patients with clinically suspected MS, 28 patients with remitting relapsing MS). MRI scans were performed using a standardized protocol, including 3D DIR, 2D FLAIR, and T2WI sequences. Lesion detection rates and regional lesion visibility were analyzed and compared. Results 3D DIR MRI significantly improved lesion detection rates, identifying 19% more lesions than 2D FLAIR and 28% more than T2WI ( P <0.001 for both). Regionally, 3D DIR MRI showed superior detection in the periventricular (13%, 23% higher), deep white matter (8%, 14% higher), juxtacortical (10%, 27% higher), intracortical (71%, 91% higher), and infratentorial (27%, 10% higher) regions compared to 2D FLAIR and T2WI, respectively ( P <0.001 for all). Conclusion 3D DIR MRI is more effective in detecting MS brain lesions than 2D FLAIR and T2WI, suggesting its integration into routine MS imaging protocols for better diagnostic accuracy.