Apparent Diffusion Coefficient in the Diagnosis and Follow-up of Multiple Sclerosis: Role of Magnetic Resonance Imaging

Abstract

Background: Chronic Multiple Sclerosis (MS) modifies the apparent diffusion coefficient (ADC) value due to severe pathological changes. After trauma, it is the second most common cause of brain injury in healthy young adults. MRI is considered the initial imaging modality for MS diagnosis and follow-up. Objective: To assess the significance of the ADC in the diagnosis and follow-up of MS plaques across various disease subtypes. Methods: Forty MS patients were included in a case-control study at Ibn-Sina Teaching Hospital, Mosul Province, between June 1, 2022 and February 28, 2023. The patients had diffusion-weighted and traditional MR imaging with ADC measurement in plaques, and the normal white matter value of controls was compared to the patients' results. Results: The ADC values were higher in cases that were acute or secondary-progressive than in relapsing-remitting cases or normal white matter. In both types of newly generated plaques, there was an initial non-significant increase in ADC values compared to existing plaques. Overall, the ADC sensitivity, specificity, and accuracy in diagnosing MS were 85.7%, 95.2%, and 90.5% in acute cases, and 85.7%, 83.3%, and 84.6% in chronic cases, respectively, with no significant difference between active and inactive lesions. Conclusions: The apparent diffusion coefficient value can be included in the imaging protocol for the diagnosis and follow-up of various subtypes of MS.