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The diagnostic utility of FLAIR imaging in clinically verified amyotrophic lateral sclerosis
Author(s) -
Zhang Lijuan,
Uluǧ Aziz M.,
Zimmerman Robert D.,
Lin Michael T.,
Rubin Michael,
Beal M. Flint
Publication year - 2003
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.10293
Subject(s) - fluid attenuated inversion recovery , amyotrophic lateral sclerosis , hyperintensity , medicine , magnetic resonance imaging , corticospinal tract , nuclear medicine , neuroimaging , white matter , radiology , pathology , disease , diffusion mri , psychiatry
Abstract Purpose To explore the overall diagnostic ability of magnetic resonance (MR) fluid‐attenuated inversion recovery (FLAIR) imaging for clinically verified amyotrophic lateral sclerosis (ALS). Materials and Methods Abnormal signal intensity in FLAIR images of 18 patients with ALS and 18 age‐matched normal controls were scored and compared. Six patients had serial MR imaging scans within 97 days. Mann Whitney U statistics and ANOVA were used for statistical analysis. Results Hyperintensity in the subcortical white matter (SWM) and the dark line along the posterior rim of the precentral gyri were found more frequently in patients with ALS. The scores for these two signs were significantly different from those of normal controls. Hyperintensity in the corticospinal tract (CST) was found in both ALS and normal controls, but the difference was not statistically significant. ANOVA on the serial FLAIR studies revealed no significant difference in the scores among the series. The hyperintensity in SWM had a sensitivity of 56% and specificity of 94%, while the dark line in the motor cortex had a 74% sensitivity and 67% specificity. Conclusion Hyperintensity in SWM and the dark line along the posterior rim of the precentral gyri appeared more frequently in the patients with ALS. SWM hyperintensity has a better specificity in association with clinically verified ALS, while the motor dark line has a better sensitivity. No correlation was found between the FLAIR findings and progression of the disease. J. Magn. Reson. Imaging 2003;17:521–527. © 2003 Wiley‐Liss, Inc.