Comparison of diffusion-weighted imaging and enhanced T1-weighted sequencing in patients with multiple sclerosis

Abstract

Introduction The purpose of this study was to assess whether demographic, brain anatomical regions and contrast enhancement show differences in multiple sclerosis (MS) patients with increased diffusion lesions (ID group) compared with diffusion restriction (DR group). Method MRI protocol comprised T1- and T2-weighted sequences with and without gadolinium (Gd), and sagittal three-dimensional FLAIR sequence, DWI and ADC maps were prospectively performed in 126 MS patients from January to December 2015. The investigation was conducted to evaluate differences in demographic, cord and brain regional, technical, and positive or negative Gd contrast imaging parameters in two groups of ID and DR. Statistical analysis was performed by using SPSS. Results A total of 9.6% of patients showed DR. In the DR group, 66.6% of the patients showed contrast enhancement of plaques, whereas 29.2% of the IR group showed enhancement of plaques. The most prevalent group was non-enhanced plaques in the ID group, followed by Gd-enhanced plaques in the ID group. Patients in the ID group (90.4%) were significantly more than in the DR group (9.6%). Out of the 40 patients with Gd-enhanced plaques, 80.5% was from the ID group and 19.5% from the DR group. Conclusion MRI of the brain, unlike of the cord, with Gd demonstrates significant difference in enhancement between the two groups ( p < 0.05). No significant difference was seen in demographic, cord and brain regional, and technical parameters, EDSS, disease duration, and attack rate as well as demographic and regional parameters between the ID and decrease diffusion groups ( p > 0.05).

Current and Future Biomarkers in Multiple Sclerosis

“…This is done by evaluating water’s apparent diffusion coefficient in the brain, which is associated with changes in cell structure and white matter tracts. Specifically, it is helpful in evaluating ischemic cerebrovascular accidents and is limited in its role in diagnosing MS as it is hindered by its inability in measuring extent of tissue loss in MS lesions [ 32 , 33 ]. Additionally, this form of imaging has a high risk of false positives [ 34 ].…”

Potential Biomarkers Associated with Multiple Sclerosis Pathology

“…The DWI estimates the so-called apparent diffusion coefficient (ADC) of water in the brain, which increases if there are alterations in cell structure and white matter tracts [ 41 ]. The technique is capable of distinguishing between different pathologies that affect the CNS, such as ischemia, infection, tumors, neurodegeneration, etc., by calculating the microscopic movement of water molecules whose diffusion is atypical in EM plaques [ 42 ]. Although this technique is useful for analyzing ischemic cerebrovascular accidents, its status as a marker of MS is not well established and it is used less than other MRI techniques.…”

“…DTI provides much more information on the pathogenesis of MS compared to T1- or T2-weighted MRI techniques. In DTI, several physical parameters are evaluated, such as: Axial diffusivity (DA) Radial diffusivity (RD); Mean diffusivity (MD); Fractional anisotropy (AF) [ 42 ]. …”

Quantification of the Brain MS Plaque Volume: Comparison of Quantitative and Qualitative Estimation of the Brain MS Plaque Volume in Successive MRI Before and After Medication Use

“…Development of new lesions can be a sign of disease progression; therefore, detection of these lesions is of great importance in monitoring the disease (20). Magnetic resonance (MR) images of the patients can be examined to determine the effectiveness of treatment and the MS plaque volume (21). Neurologists or radiologists often compare successive images visually or subjectively in med-ical centers, which may lead to some human errors.…”