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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Anatomical distribution of central nervous system plaques in multiple sclerosis: an Iranian experience
Zinat Miabi1, Mehran Midia, Ramin Midia
1Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract:
Multiple Sclerosis (MS) begins most commonly in young adults and is characterized by multiple areas of Central Nervous System (CNS) white matter inflammation, demyelination and glial scarring. The most valuable laboratory aid for diagnosing MS is Magnetic Resonance Imaging (MRI). An advanced type of MRI that exploits molecular diffusion can detect acute and active lesions. Early diagnosis and onset of treatment help to hinder disease progression. The aim of this study was to compare the findings of conventional and Diffusion-Weighted (DW) MRI in assessing the cerebral lesions of MS patients. Thirty patients with clinically definite MS (mean age 32.76 +/- 8.79 years) and an age- and sex-matched control group of 30 healthy volunteers (mean age 32.75 +/- 9.23 years) were enrolled in this 12 month descriptive-prospective survey. Both groups were subjected to conventional and DW MRI and were compared in respect of the total number, morphology, location and the mean size of the intra-cerebral MS plaques. The sensitivities and specificities of both imaging methods in detecting these plaques were determined. The conventional method revealed significantly more plaques within the brain (p < 0.05) and showed more ovoid lesions. More lesions were detected by the conventional method in the periventricular area, centrum semiovale and corpus callosum. The minimum plaque size was significantly lower in the conventional method group. The sensitivity of both methods was 100%. The specificities of conventional and DW MRI were 86.6 and 96.6%, respectively, so DW MRI may detect lesions that are not obvious by routine methods.
Insights
Diffusion-Weighted (DW) MRI offers higher specificity than conventional MRI for detecting Multiple Sclerosis (MS) cerebral lesions. While conventional MRI identified more lesions, DW MRI proved more adept at spotting subtle, active MS plaques.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple Sclerosis (MS) is a CNS inflammatory disease affecting young adults, characterized by demyelination and glial scarring.
- Magnetic Resonance Imaging (MRI) is crucial for MS diagnosis, with advanced techniques like Diffusion-Weighted (DW) MRI showing potential for detecting active lesions.
- Early diagnosis and treatment are vital for managing MS progression.
Purpose of the Study:
- To compare the diagnostic efficacy of conventional MRI and Diffusion-Weighted (DW) MRI in evaluating cerebral lesions in Multiple Sclerosis (MS) patients.
- To assess the sensitivity and specificity of both imaging modalities for detecting MS plaques.
Main Methods:
- A descriptive-prospective study involving 30 clinically definite MS patients and 30 age/sex-matched healthy controls over 12 months.
- Both groups underwent conventional and Diffusion-Weighted (DW) MRI scans.
- Comparison focused on plaque number, morphology, location, size, and detection sensitivity/specificity.
Main Results:
- Conventional MRI detected a significantly higher number of cerebral plaques (p < 0.05), with more ovoid lesions and a lower minimum detectable plaque size.
- Conventional MRI identified more lesions in the periventricular area, centrum semiovale, and corpus callosum.
- Both methods achieved 100% sensitivity, but DW MRI demonstrated higher specificity (96.6%) compared to conventional MRI (86.6%).
Conclusions:
- Diffusion-Weighted (DW) MRI is a valuable tool for detecting subtle or active cerebral lesions in Multiple Sclerosis (MS) that may be missed by conventional MRI.
- DW MRI's superior specificity suggests its utility in enhancing the accuracy of MS lesion assessment and potentially aiding in earlier diagnosis.
