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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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How Common Is Signal-Intensity Increase in Optic Nerve Segments on 3D Double Inversion Recovery Sequences in Visually

T Sartoretti1, E Sartoretti1, S Rauch1

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3D double inversion recovery MR imaging effectively detects subclinical optic nerve demyelination in multiple sclerosis (MS) patients. This advanced MRI technique identifies lesions in visually asymptomatic individuals, aiding early diagnosis.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Subclinical optic nerve demyelination is prevalent in multiple sclerosis (MS) but challenging to detect radiologically.
  • Conventional MRI sequences like STIR T2WI have limitations in visualizing these subtle lesions.

Purpose of the Study:

  • To assess the efficacy of 3D double inversion recovery (3D DIR) MR imaging in detecting subclinical demyelinating lesions in various optic nerve segments.
  • To evaluate the diagnostic performance of 3D DIR compared to existing methods.

Main Methods:

  • Evaluated signal intensities in four optic nerve segments (retrobulbar, canalicular, prechiasmatic, chiasm) using 3D DIR MRI.
  • Included 95 MS patients without recent visual symptoms and 50 controls.
  • Compared optic nerve signal intensities to the adjacent lateral rectus muscle, with evaluations by both expert and student readers.

Main Results:

  • Optic nerve segments in controls showed hypointensity on 3D DIR, with an isointense sheath around the retrobulbar segment.
  • 68% of MS patients exhibited isointense or hyperintense signals in at least one optic nerve segment, as determined by the expert.
  • Student readers achieved 97% accuracy in identifying optic nerve hypersignal.

Conclusions:

  • 3D DIR MRI reveals optic nerve hypersignal in a high percentage of visually asymptomatic MS patients, indicating subclinical demyelination.
  • This sequence is a valuable tool for detecting early optic nerve involvement in MS.
  • Signal intensity assessment by inexperienced readers is reliable, suggesting potential for broader clinical application.