One step diagnosis of multiple sclerosis disease activity, dissemination in time and space using diffusion weighted MRI

Abstract

ObjectivesTo assess the value of DWI with its two components (DWI-b1000 and DWI b0) images in assessment of active MS and in defining dissemination in time (DIT) and dissemination in space (DIS) in those patients. MethodsBrain MRI studies were performed using T1WI, T2WI, FLAIR and DWI and CE T1WI. ResultsTwenty-one patients (Males/Females=6/15)of age range 18–50 years were included. Forty lesions were hyperintense on DWI-b1000 that had significant link to enhancement seen on contrast-enhanced T1WI (100%) indicating disease activity. Using the 2010 revised McDonald criteria: In 9 patients (42.85%), there were [Asymptomatic active lesions (n=17)]. Those lesions were simultaneously present along with [Non-active demyelinating lesions]; DIT could be diagnosed in these cases based alone on MRI findings. In 12 patients (57.14%), there was simultaneous presence of [Symptomatic active lesions (n=23)]. Those lesions were present along with [Non-active demyelinating lesions]; DIT could be diagnosed in these cases based on both clinical and MRI findings. ConclusionDWI-b1000 is of the same sensitivity as CE T1WI in detection of MS active lesions and in detection of DIT and DIS. DWI-b0 can substitute the T2WI in detection of demyelinating lesions and in confirmation of the MS disease beyond the active stage.