Davoudi Yasmin, Foroughipour Mohsen, Torabi Reza, Layegh Parvaneh, Matin Nassim, Shoeibi Ali
Department of Radiology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Radiol. 2016 Feb 15;13(2):e21740. doi: 10.5812/iranjradiol.21740. eCollection 2016 Apr.
Multiple 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.
This 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).
In 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.
CE-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.
These 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.
多发性硬化症（MS）是中枢神经系统最常见的自身免疫性疾病之一。尽管有多种成像方式，但MS的明确诊断仍然具有挑战性。
本研究旨在评估扩散加权成像（DWI）在急性MS发作诊断中的实用性，并将其结果与对比增强磁共振成像（CE-MRI）进行比较。
在这项横断面研究中，纳入了70例明确诊断为复发缓解型MS的患者。所有患者均进行了使用0.1 mmol/kg钆的CE-MRI以及DWI序列检查。将DWI阳性患者的百分比与CE-MRI的结果进行比较，并评估两种成像方式之间的一致性。此外，还研究了患者症状发作时间与两种检查结果之间的关系。
CE-MRI对61例（87%）患者产生阳性结果，DWI对53例（76%）患者产生阳性结果。在50例患者（71.42%）中，两种检查均为阳性，在6例患者（8.57%）中两者均为阴性。3例患者的DWI检查结果为阳性，而CE-MRI检查结果为阴性。CE-MRI和DWI的结果与症状发作后成像时间之间没有显著关系。
这些数据表明，虽然CE-MRI会显示更多阳性结果，但在某些情况下，DWI会显示阳性结果而CE-MRI为阴性。我们建议，这两种成像方式的结合可能会在诊断急性MS发作时产生更多阳性结果，从而实现更准确的诊断。
