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Updated: Mar 10, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
The evaluation of MRI diffusion values of active demyelinating lesions in multiple sclerosis
Mohammad Abdoli1, Santanu Chakraborty2, Heather J MacLean3
1University of Ottawa, Canada.
Background:
Gadolinium (Gd) enhancement of lesions is the main radiologic marker for detection of activity in Multiple Sclerosis (MS). This study compares Diffusion weighted imaging (DWI) characteristics and enhancement to determine whether DWI can be used as an alternative to Gd administration.
Methods:
A retrospective study of 72 patients who had MRI with Gd and DWI. Visual assessment and comparison of the Apparent Diffusion Coefficient (ADC) values on Gd+ lesions, all lesions showing restricted diffusion, 2 Gd- lesions and 1 area of normal-appearing white matter (NAWM) in each MRI were performed.
Results:
DWI values were measured on 275 T2 lesions, 68 Gd+ and 207 Gd- lesions, as well as 104 NAWM. 34 Gd+ lesions showed restricted diffusion. The median ADC-minimum of Gd+ lesions was significantly lower than NAWM and even lower than Gd- lesions. Most DWI restricted lesions were also Gd+(specificity≥94%), however many Gd+ lesions did not show visually detectable restriction in DWI (sensitivity≤34%). The median ADC-minimum of symptomatic lesions was lower than asymptomatic lesions.
Conclusion:
While Gd+ lesions have lower ADC-minimum, visual DWI assessment cannot replace Gd administration for identifying active lesions. Gd+ lesions showing restricted diffusion are clinically important as they are more likely associated with neurological symptoms.
Insights
Diffusion weighted imaging (DWI) shows potential for detecting active Multiple Sclerosis (MS) lesions, with restricted diffusion correlating to gadolinium (Gd) enhancement. However, DWI visual assessment alone is insufficient to replace Gd administration for identifying all active MS lesions.
Area of Science:
- Radiology
- Neuroimaging
- Multiple Sclerosis (MS)
Background:
- Gadolinium (Gd) enhancement is the primary MRI marker for active Multiple Sclerosis (MS) lesions.
- Diffusion weighted imaging (DWI) offers a non-contrast alternative for lesion detection.
Purpose of the Study:
- To compare DWI characteristics with Gd enhancement in MS lesions.
- To evaluate DWI's potential as a substitute for Gd administration in MS activity detection.
Main Methods:
- Retrospective analysis of 72 MS patients with both Gd-enhanced and DWI MRI scans.
- Visual assessment and Apparent Diffusion Coefficient (ADC) value comparison of Gd-enhancing (Gd+) and non-enhancing (Gd-) lesions, and normal-appearing white matter (NAWM).
Main Results:
- Gd+ lesions exhibited significantly lower median ADC-minimum values compared to NAWM and Gd- lesions.
- Most DWI-restricted lesions were Gd+ (specificity ≥94%), but many Gd+ lesions lacked visually detectable DWI restriction (sensitivity ≤34%).
- Symptomatic lesions showed lower median ADC-minimum values than asymptomatic lesions.
Conclusions:
- While Gd+ lesions demonstrate reduced ADC-minimum values, visual DWI assessment cannot replace Gd administration for identifying active MS lesions.
- DWI-restricted Gd+ lesions are clinically significant, correlating with neurological symptoms.
