Detection of Active Plaques in Multiple Sclerosis using ۳ and ۱۲ Directional Diffusion-weighted Imaging: Comparison with Gadolinium-enhanced MR Imaging

Background: Multiple Sclerosis (MS), distinguished by aggravating the function of central nervous system because of inflammatory demyelination. The most sensitive method for MS diagnosis is Magnetic resonance imaging (MRI). To distinguish inactive and active MS lesions, contrast-enhanced T۱-weighted imaging (CE T۱WI) is being used as a gold standard. There are some contraindications in gadolinium based contrast agents (GBCAs) usage. Moreover, diffusion-weighted imaging (DWI) can discover diffusion changes involved inflammatory lesions. Objective: The current research aims at investigating if typical DWI (۳ directional) and ۱۲ directional DWI could be a substitute for CE T۱WI in order to show active lesions of MS.Material and Methods: In this cross-sectional study, ۱۳۸ patients with CNS symptoms were examined. For all patients, along with CE T۱WI, ۳ & ۱۲ directional DWI were performed. Intraclass correlation coefficient (ICC), receiver operating characteristic (ROC), the sensitivity versus specificity plot and the area under the curve (AUC) were calculated. Results: There was a contrast enhancement in CE T۱WI for ۱۱۴ patients (۸۲.۶%); in addition, hyper-intense lesions on DWI ۳ and DWI ۱۲ were shown in ۱۰۷ (۷۷.۵%) and ۱۱۷ patients (۸۴.۷%) in order. Sensitivity, specificity and AUC were ۹۴.۷%, ۶۲.۵% and ۸۴% for DWI ۱۲. Moreover, the results were ۸۶%, ۶۲.۵ and ۷۹% for the sensitivity, specificity and AUC for DWI ۳ respectively. Conclusion: In spite of lower sensitivity of ۱۲ directional DWI compared to CE T۱WI, it could be used as a diagnostic sequence in differentiating enhanced lesions from non-enhanced ones when CE-MRI is a worry.

کلیدواژه ها:

Demyelinating diseases ، Magnetic Resonance Imaging ، Diffusion tensor imaging ، Gadolinium ، Multiple Sclerosis