Biplanar MRI for the assessment of the spinal cord in multiple sclerosis
Multiple Sclerosis Journal,  Continuing Medical Education  Clinical Article

Weier K et al. – Biplanar MRI facilitates a comprehensive identification, localization, and grading of pathological spinal cord (SC) findings in multiple sclerosis (MS) patients. This improves the confidence and utility of SC imaging.

Methods
  • Two hundred and two patients (140 women, 62 men 24-74 years, Expanded Disability Status Scale (EDSS) scores 0-7.5) were investigated clinically and with biplanar MRI.
  • Sagittal and axial proton density weighted (PDw) and T2 weighted (T2w) images of the whole SC were obtained employing parallel imaging.
  • Data were analyzed by consensus reading using a standardized reporting scheme.
  • Different combinations of findings were compared to EDSS scores with Spearman’s rank correlation coefficient (ρ).

Results
  • The combined analysis of sagittal and axial planes demonstrated slightly differing results in 97/202 (48%) patients.
  • There were 9% additional lesions identified, leading to a higher lesion count in 28% of these patients, but also rejection of equivocal abnormality leading to a lower lesion count in 11% of patients.
  • Considering both sagittal and axial images, SC abnormalities were found in 167/202 (83%) patients.
  • When compared with EDSS scores, the combination of focal lesions, signs of atrophy and diffuse abnormalities showed a moderate correlation (ρ =0.52), that precludes its use for individual patient assessment.

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