Brain 3D-FLAIR matches dedicated optic nerve STIR for lesion detection in CIS

Brain 3D-FLAIR showed near-perfect agreement (Cohen's Kappa 0.961) with dedicated optic nerve 2D-STIR in detecting optic nerve lesions in clinically isolated syndrome, with accuracy 93.1% vs 91.2%. It may serve as an alternative in routine brain MRI.

• Both sequences had 100% sensitivity; specificity was 85.5% for 2D-STIR and 88.7% for 3D-FLAIR.
• In non-symptomatic eyes, 2D-STIR detected slightly more lesions (14.5% vs 11.3%).
• 2D-STIR-positive eyes showed significantly worse visual function and thinner retinal layers on optical coherence tomography.

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