Background: Multiple sclerosis (MS) is a demyelinating disease, involving almost 2. 5 million people around the world. There are different MR pulse sequences, which are used to detect MS plaques. Objectives: This study aimed to compare, T2 weighted, short-tau inversion recovery (STIR) and phase-sensitive inversion recovery (PSIR) pulse sequences, for detecting cervical spinal cord lesions in MS patients. Patients and Methods: Sixty patients with definite MS diagnoses, participated in this study from June to December 2016. 1. 5 T Siemens (Avanto, Erlangen, Germany) MR scanner and three pulse sequences (T2 weighted, STIR and PSIR sequences) were used for cervical cordMRimaging. To assess the effectiveness of these pulse sequences, the lesion to cord ratio (LCR) and lesion to noise ratio (LNR) were calculated. Results: The LCR and LNR of the T2 and PSIR were the same (LCR of 0. 04,-0. 03 and LNR of 2. 74,-2. 09 respectively), just the intensities were reverse. STIR had a significantly different LCR and LNR [0. 23 (P < 0. 001) and 22. 7(P < 0. 001) respectively], hence it was better in diagnosing cervical cord MS plaques. Conclusion: According to the results, using 1. 5 T MRI machine, it implies that the STIR pulse sequence was the best pulse sequence in comparison to T2 and PSIR in detecting cervical cord MS plaques.

Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that causes demyelination or loss of myelin in the white and gray matter of the brain and spinal cord. Objectives: In the current study, the phase sensitive inversion recovery (PSIR) sequence was compared with the other sequences (T2-weighted (T2W), short tau inversion recovery (STIR)) to represent the number and conspicuity of the lesions. Patients and Methods: In this study, 35 MS patients were referred to the imaging center for MRI of the cervical spine. In the sagittal view, T2 weighted turbo spin echo (T2TSE), STIR, and PSIR and in the axial view, T2 TSE, and PSIR sequences were compared. The sequences were compared regarding the number of lesions and conspicuity. P value < 0. 05 was considered statistically significant. Results: In sagittal view MRIs, mean plaque number in T2TSE, STIR and PSIR were 1. 7  1. 1, 3. 5  1. 4, and 3. 4  1. 4, respectively (P < 0. 001; PSIR and STIR were greater than T2TSE but their difference was not statistically significant). Regarding comparison of imaging conspicuity, most of the plaques in PSIR showed good resolution (75%). In fact, the highest conspicuity of plaques was detected in PSIR (P < 0. 001). In axial view MRIs, comparing mean plaque count and conspicuity of lesions, PSIR showed better results than T2TSE (P < 0. 001). Conclusion: PSIR sequence showed high sensitivity and precision in the detection of plaques in the cervical spine. PSIR sequence is efficient as a complementary sequence in evaluating the cervical lesions of MS patients. It could increase the diagnostic accuracy in these patients.

Background: Precise detection and classification of intracortical (IC) lesions in multiple sclerosis (MS) patients are very important for understanding their role in disease progression and determining their effects on the clinical presentations of the disease. Objectives: This study aimed to evaluate the efficacy of phase-sensitive inversion recovery (PSIR) in delineation of cortical lesions in MS patients. Patients and Methods: This cross-sectional, single-center study was performed among 38 patients with the mean age of 31 years, who were recruited from December 2018 to August 2020. All MS patients underwent magnetic resonance imaging (MRI), using a 1. 5-Tesla scanner. Two expert neuroradiologists interpreted the fluid-attenuated inversion recovery (FLAIR), T2-weighted turbo spin echo (T2W-TSE), and PSIR images. The lesions were classified as purely IC, mixed gray/white matter (WM) [leukocortical (LC)], and juxtacortical (JC). The number of lesions in each region was compared between the FLAIR, T2W-TSE, and PSIR sequences. Results: The number of cortical lesions (IC and LC) was significantly higher in PSIR compared to T2W-TSE and Fluid attenuated inversion recovery (FLAIR) (P < 0. 001), while the number of JC lesions was lower; in other words, the mean number of plaques was higher in T2W-TSE and FLAIR as compared to PSIR. Conclusion: The PSIR sequence significantly improved the delineation of cortical lesions and could be useful in monitoring cortical injuries and disease progression in MS patients.