Diagnostic Value of Double Inversion Recovery MRI in the Evaluation of Brain Lesions in Multiple Sclerosis

Abstract

Background: Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system characterized by focal demyelinated plaques, inflammation, gliosis, neurodegeneration, and diffuse injury in normal-appearing tissue. Conventional magnetic resonance imaging (MRI) is central to diagnosis and monitoring but has limited sensitivity for cortical and grey matter lesions.

Objective: To review the pathological and clinical basis of MS imaging and the role, technical principles, clinical applications, advantages, and limitations of double inversion recovery (DIR) in the evaluation of MS brain lesions.

Conclusion: DIR provides valuable complementary information in MS brain imaging, particularly for cortical and juxtacortical lesions. It should complement rather than replace conventional T2-weighted and FLAIR sequences because lesion conspicuity remains dependent on anatomical location and sequence characteristics.