Early Contrast-Enhanced Magnetic Resonance Imaging with Fluid-Attenuated Inversion Recovery in Multiple Sclerosis

OBJECTIVE Contrast-enhanced magnetic resonance imaging (MRI) with fluid-attenuated inversion recovery (contrast FLAIR) is particularly useful for the detection of meningeal lesions. However, whether contrast FLAIR is useful in multiple sclerosis (MS) remains uncertain. This study evaluated the usefulness of contrast FLAIR in MS. PATIENTS AND METHODS We prospectively studied the clinical histories and brain MRI studies of 6 patients with clinically definite MS diagnosed according to the new McDonald criteria. Contrast FLAIR (repetition time [TR] 9,000 ms; echo time [TE] 120 ms; inversion time [TI] 2,200 ms; 5-mm slice thickness, with a 1-mm interslice gap) was obtained with the use of a bolus of gadolinium diethylenetriamine pentaacetic acid. RESULTS Three enhancing plaques located in the periventricular or juxtacortical areas showed higher intensity on contrast FLAIR than on other MR sequences. In contrast, 8 enhancing plaques in the deep white matter or infratentorial areas showed no increased signals on contrast FLAIR. CONCLUSION Our findings suggest that early contrast-enhanced imaging with FLAIR may be helpful for the further detection of MS plaques, particularly those located in periventricular and juxtacortical lesions. J Neuroimaging 2009;19:246-249.