Determination of Activity of Multiple Sclerosis (MS) Lesions in the Brain by Different Magnetic Resonance Imaging (MRI) Pulse Sequences

Abstract

Background: Multiple sclerosis is one of the commonest causes of chronic neurological disability in young and middle aged people. MRI offers a unique in-vivo investigative tool for its evaluation. Aim of Study: To reveal the value of different MRI pulse sequences in evaluation of multiple sclerosis affection of the brain. Patients and Methods: This is a prospective hospital analytic study enrolling 25 patients diagnosed to have definite multiple sclerosis according to the McDonald's Criteria for diagnosing multiple sclerosis during the period from April 2016 to February 2017. The study was conducted in the MRI Unit of the Radiology Department of Assiut University Hospital. Results: All the enhancing lesions showed restricted diffusion in DW images at high b values accounting for 100% sensitivity and negative predictive value of DWI pulse sequence. On the other hand, some of the non-enhancing MS lesions, showed diffusion restriction in DW images, assuming a positive predictive value and specificity of 36.3% and 94% respectively. Post-contrast Magnetization Transfer Contrast (MTC) images could significantly detect higher number of enhancing MS lesions than standard T1W-SE images. All the enhancing lesions depicted on post-contrast T 1 W-SE sequence were also seen enhancing in MTC images, but more conspicuous. Conclusion: Diffusion weighted imaging and magnetization transfer imaging provide suitable investigative tools for determination of multiple sclerosis activity.