The contribution of diffusion-weighted MR imaging in multiple sclerosis during acute attack

Yurtsever, İsmail; Hakyemez, Bahattin; Taşkapılıoğlu, Özlem; Erdoğan, Cüneyt; Turan, Ömer Faruk; Parlak, Müfıt

doi:10.1016/j.ejrad.2007.05.002

Cited by 20 publications

(16 citation statements)

References 27 publications

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“…Type IVB lesions show elevated diffusion and no enhancement on CE T1WI that may be due to axonal loss and gliosis with widening of the extracellular space. They may even form “T1 black holes” on MRI, representing irreversible tissue destruction [10-12,14,19,20]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of diffusion-weighted imaging and contrast-enhanced T1-weighted imaging on a single baseline MRI for demonstrating dissemination in time in multiple sclerosis

Kao

Chen

et al. 2014

BMC Neurol

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BackgroundThe 2010 Revisions to the McDonald Criteria have established that dissemination in time (DIT) of multiple sclerosis (MS) can be demonstrated by simultaneous presence of asymptomatic gadolinium-enhancing and nonenhancing lesions on a single magnetic resonance imaging (MRI). However, gadolinium-based contrast agents (GBCAs) have contraindications. Diffusion-weighted imaging (DWI) can detect diffusion alterations in active inflammatory lesions. The purpose of this study was to investigate if DWI can be an alternative to contrast-enhanced T1-weighted imaging (CE T1WI) for demonstrating DIT in MS.MethodsWe selected patients with clinically definite MS and evaluated their baseline brain MRI. Asymptomatic lesions were identified as either hyperintense or nonhyperintense on DWI and enhancing or nonenhancing on CE T1WI. Fisher’s exact test was performed to determine whether the hyperintensity on DWI was related to the enhancement on CE T1WI (P < 0.05). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the DWI to predict lesion enhancement were calculated.ResultsTwenty-two patients with 384 demyelinating lesions that were hyperintense on T2-weighted imaging and more than 3 mm in size were recruited. The diffusion hyperintensity and lesion enhancement were significantly correlated (P <0.001). The sensitivity, specificity, PPV, NPV and accuracy were 100%, 67.9%, 32.3%, 100% and 72.1%, respectively.ConclusionsA hyperintense DWI finding does not necessarily overlap with contrast enhancement. There are many false positives, possibly representing other stages of lesion development. Although DWI may not replace CE T1WI imaging to demonstrate DIT due to the low PPV, it may serve as a screening MRI sequence where the use of GBCAs is a concern.

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Section: Discussionmentioning

confidence: 99%

Comparison of diffusion-weighted imaging and contrast-enhanced T1-weighted imaging on a single baseline MRI for demonstrating dissemination in time in multiple sclerosis

Kao

Chen

et al. 2014

BMC Neurol

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“…11,31 It measures the microscopic random translational motion of water molecules and so can assess the free water content of the cerebral tissue. It has been used in the differential diagnosis of various pathologies, including ischemia, infection, demyelinating plaques, and tumor.…”

Section: Discussionmentioning

confidence: 99%

“…15,32 Diffusion of the water molecules is affected by the microstructures and the microdynamic process; thus, ADC can be measured quantitatively. 31 DWI has identifi ed, in several brain conditions, tissue changes that are not visible on routine cranial MRI. It has been suggested as a useful tool for evaluating the nature and extent of the structural injury in WD patients.…”

Section: Discussionmentioning

confidence: 99%

Structural and neurochemical evaluation of the brain and pons in patients with Wilson’s disease

Algın¹,

Taşkapılıoğlu

Hakyemez

et al. 2010

Jpn J Radiol

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“…Since the primary inflammatory changes in MS consist of the cytotoxic type of edema followed by vasogenic edema, it may induce alterations in apparent diffusion coefficient (ADC), an index used in DWI. In fact, diffusion weighted imaging (DWI) has shown alterations in the white matter in acute MS patients ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Diffusion Weighted Imaging in Acute Attacks of Multiple Sclerosis

et al. 2016

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BackgroundMultiple sclerosis (MS) is one of the most common autoimmune disorders of the central nervous system. In spite of various imaging modalities, the definitive diagnosis of MS remains challenging.ObjectivesThis study was designed to evaluate the usefulness of diffusion weighted imaging (DWI) in the diagnosis of acute MS attack and to compare its results with contrast enhanced MRI (CE-MRI).Patients and MethodsIn this cross sectional study, seventy patients with definite diagnosis of relapsing-remitting MS were included. CE-MRI using 0.1 mmol/kg gadolinium as well as DWI sequences were performed for all patients. The percentage of patients with positive DWI was compared with the results of CE-MRI and the consistency between the two imaging modalities was evaluated. Moreover, the relationship between the time of onset of patient’s symptoms and test results for both methods were investigated.ResultsCE-MRI yielded positive results for 61 (87%) patients and DWI yielded positive for 53 (76%) patients. In fifty patients (71.42%), both tests were positive and in six cases (8.57%), both were negative. The test results of three patients turned out to be positive in DWI, while they tested negative in CE-MRI. There was no significant relationship between the results of CE-MRI as well as DWI and the time of imaging from the onset of symptoms.ConclusionThese data indicate that while CE-MRI will depict more positive results, there are cases in which DWI will show a positive result while CE-MRI is negative. We suggest that the combination of these two imaging modalities might yield more positive results in diagnosing acute MS attack giving rise to a more accurate diagnosis.

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The contribution of diffusion-weighted MR imaging in multiple sclerosis during acute attack

Cited by 20 publications

References 27 publications

Comparison of diffusion-weighted imaging and contrast-enhanced T1-weighted imaging on a single baseline MRI for demonstrating dissemination in time in multiple sclerosis

Comparison of diffusion-weighted imaging and contrast-enhanced T1-weighted imaging on a single baseline MRI for demonstrating dissemination in time in multiple sclerosis

Structural and neurochemical evaluation of the brain and pons in patients with Wilson’s disease

Diffusion Weighted Imaging in Acute Attacks of Multiple Sclerosis

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