Diffusion-Weighted Magnetic Resonance Imaging of the Brain in Multiple Sclerosis

Murat Terzi; Köksal Atalay; Lütfi İncesu; Barış Diren; Musa Onar

Murat Terzi¹, Köksal Atalay², Lütfi İncesu², Barış Diren², Musa Onar¹

¹Department Of Neurology, Ondokuz Mayıs University, Faculty Of Medicine, Samsun, Turkey
²Department Of Radiology, Ondokuz Mayıs University, Faculty Of Medicine, Samsun, Turkey

Keywords: Multiple sclerosis, diffusion magnetic resonance imaging, tissue damage

Abstract

OBJECTIVE: MRI. Diffusion-weighted MRI (DW-MRI) offers the possibility of differentiating such lesions from ischaemic lesions by using objective data as well as determining active MS plaque in particular.

OBJECTIVES: This present study investigated diffusion alterations in MS patients in plaques and the normal-appearing white matter.

METHODS: A total of 45 patients had been diagnosed with MS according to Mc Donald’s criteria were enrolled in the study. Cranial MRI examination consisted of number of lesions in PD/T2 transverse, T2 sagittal, T2 FLAIR transverse, diffusion-weighted MRI and ADC mapping, heavy IR-T1 transverse, T1 transverse, postcontrast T1 transverse imaging, incidence ratio in all sequences as well as assessment of contrasting characteristics. Visual characteristics of the lesions were determined in diffusion-weighted MRI and ADC mapping.

RESULTS: Mean ADC values measured in the normal appearing white matter according to clinical forms were as follows: 0.79 ± 0.15x10-3 mm2/sec for RRMS, 0.8 ± 0.15x10-3 mm2/sec PPMS and 0.82 ± 0.15x10-3 mm2/sec for SPMS. The differences between clinical forms in terms of mean ADC values measured in the normal appearing white matter were statistically significant (p<0.05). Mean ADC values measured in T1 isointense lesions were O.97 ± 0.15x10-3 mm2/sec for RRMS, 0.98 ± 0.15x10-3 mm2/sec for PPMS and 0.99 ± 0.15x10-3 mm2/sec for SPMS. The differences between the groups were not statistically significant (p>0.05). Mean ADC values measured in T1 hypointense lesions were 1.106 ± 0.15x10-3 mm2/sec for RRMS, 1.119 ± 0.15x10-3 mm2/sec for PPMS and 1.132 ± 0.15x10-3 mm2/sec for SPMS. The differences between the groups were statistically significant (p<0.05).

CONCLUSION: DW-MRI revealed increased diffusion in chronic lesions, acute lesions and normal-appearing white matter in all patients in this present study. Mean ADC value established in acute lesions was 1.062± 0.15x10-3 mm2/sec, while it was 1.118 ± 0,15x10-3 mm2/sec in T1 hypointense lesions and 0.985 ± 0.12x10-3 mm2/sec in T1 isointense lesions. Significantly higher ADC values in T1 hypointense lesions and acute lesions indicated more severe tissue damage in those lesions.