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Diffusion-weighted MR imaging in multiple sclerosis: comparison with contrast-enhanced study
K Tsuchiya1, J Hachiya, T Maehara
1Department of Radiology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. rxl03761@nifty.ne.jp
Objective:
To assess the utility of cerebral diffusion-weighted MR imaging in the diagnosis of multiple sclerosis (MS) in comparison with contrast-enhanced T1-weighted imaging.
Methods And Materials:
We reviewed T2-weighted spin-echo (SE), fluid-attenuated inversion-recovery (FLAIR), contrast-enhanced T1-weighted SE and echo-planar diffusion-weighted images (DWIs) obtained in seven patients with definite MS on nine occasions.
Results:
In total, 94 plaques were demonstrated on T2-weighted SE and/or FLAIR images. A total of 13 of these plaques showed enhancement on contrast-enhanced T1-weighted images and hyperintensity on DWIs, and five non-enhancing plaques showed hyperintensity on DWIs.
Conclusion:
Diffusion-weighted imaging, which provides information based on pathophysiology different from contrast-enhanced imaging, is a potential supplementary technique for characterizing MS plaques.
Insights
Cerebral diffusion-weighted MRI (DWI) shows promise in diagnosing multiple sclerosis (MS) by detecting plaques that may not be visible with contrast-enhanced T1-weighted imaging alone.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
- Accurate diagnosis and characterization of MS lesions are crucial for effective management.
- Conventional MRI sequences have limitations in fully characterizing MS plaques.
Purpose of the Study:
- To evaluate the diagnostic utility of cerebral diffusion-weighted magnetic resonance imaging (DWI) for multiple sclerosis (MS).
- To compare the effectiveness of DWI with contrast-enhanced T1-weighted imaging in identifying MS plaques.
- To explore DWI as a supplementary tool for characterizing MS lesions.
Main Methods:
- Review of MRI scans from seven patients with definite MS.
- Acquisition of T2-weighted spin-echo (SE), FLAIR, contrast-enhanced T1-weighted SE, and echo-planar diffusion-weighted images (DWIs).
- Analysis of 94 MS plaques identified on T2-weighted SE and/or FLAIR images.
Main Results:
- Diffusion-weighted imaging (DWI) detected hyperintensity in 13 enhancing plaques and 5 non-enhancing plaques.
- Contrast-enhanced T1-weighted imaging identified enhancement in 13 plaques.
- DWI revealed additional plaque information beyond contrast enhancement.
Conclusions:
- Diffusion-weighted imaging (DWI) offers unique pathophysiological insights distinct from contrast-enhanced MRI.
- DWI is a valuable supplementary technique for characterizing multiple sclerosis plaques.
- Integrating DWI may improve the comprehensive assessment of MS lesions.