OPTIC NEURITIS - MR-IMAGING WITH COMBINED FAT-SUPPRESSION AND WATER-SUPPRESSION TECHNIQUES

PURPOSE: To examine the benefits of combined fat- and water-suppressed T2-weighted magnetic resonance (MR) images in the diagnosis of optic neuritis. MATERIALS AND METHODS: MR imaging was preformed with a 1.5-T unit in five healthy volunteers and 18 patients (21 nerves). All pati ents had abnormalities of visual evoked potentials and fulfilled the c linical criteria for the diagnosis of optic neuritis. Imaging was perf ormed within 4 weeks of diagnosis (n = 12) or between 3 and 6 months a fter diagnosis (n = 6). Coronal images were obtained throughout the co urse of the optic nerve with use of three sequences: (a) short inversi on time inversion recovery with fast spin-echo (SE) acquisition, (b) s elective partial inversion-recovery (SPIR) prepared T2-weighted fast S E acquisition, and (c) SPIR-fluid-attenuated inversion recovery (FLAIR ) with fast SE acquisition. RESULTS: Neuritic segments were demonstrat ed in all 21 symptomatic nerves. The extent of neuritic involvement (n umber of images showing abnormality) was significantly greater with th e SPIR-FLAIR sequence (P < .01). The contrast ratio between neuritic o ptic nerve and orbital fat, normal nerve, and cerebral spinal fluid wa s significantly greater with SPIR-FLAIR than with the other sequences (P < .001). SPIR-FLAIR images also improved demonstration of optic ner ve atrophy in chronic neuritis when compared with the other sequences. CONCLUSION: The SPIR-FLAIR sequence offers important advantages over current methods in the demonstration of optic neuritis.