ADC value as a predictor for myelin loss/Preservation in MS plaques with different enhancement pattern in correlation with disease activity

Abstract

BackgroundMS plaques display different pattern of enhancement with variable clinical course. The purpose is to assess the role of ADC value as a predictive for MS histologic changes with different enhancing pattern and its correlation with disease activity. Patients and methodsThis prospective study included 28 chronic MS patients with 75 lesions, subjected for magnetic resonance imaging and ADC value measurement of the plaques and normally appearing white matter (NAWM) to be correlated with that of normal white matter (NWM) in 20 healthy controls. ResultsT1-Hypointense and confluent lesions had statistical significant higher mean ADC value relative to the isointense and discrete lesions. Statistical significance difference was detected between mean ADC value of homogeneously enhancing lesions (HELs) and ring enhancing lesions (RELs) and between HELs and non-enhancing lesions (NELs), but no difference between NELs and RELs. Statistical significance difference was detected between ADC of NAWM relative to NWM of healthy controls. ConclusionADC value predicts histological changes in MS lesions. Pattern of enhancement doesn't correlate with neurologic deficits but ADC value is more valuable in assessing the disease activity.