Alomair Othman I, Alghamdi Sami A, Abujamea Abdullah H, AlfIfi Ahmed Y, Alashban Yazeed I, Kurniawan Nyoman D
Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia.
King Salman Centre for Disability Research, Riyadh 11614, Saudi Arabia.
Diagnostics (Basel). 2025 May 15;15(10):1260. doi: 10.3390/diagnostics15101260.
: Multiple sclerosis (MS) is a chronic and heterogeneous disease characterized by demyelination and axonal loss and damage. Magnetic resonance imaging (MRI) has been employed to distinguish these changes in various types of MS lesions. We aimed to evaluate intravoxel incoherent motion (IVIM) diffusion and perfusion MRI metrics across different brain regions in healthy individuals and various types of MS lesions, including enhanced, non-enhanced, and black hole lesions. A prospective study included 237 patients with MS (65 males and 172 females) and 29 healthy control participants (25 males and 4 females). The field strength was 1.5 Tesla. The imaging sequences included three-dimensional (3D) T, 3D fluid-attenuated inversion recovery, two-dimensional (2D) T, T-weighted imaging, and 2D diffusion-weighted imaging (DWI) sequences. IVIM-derived parameters-apparent diffusion coefficient (ADC), pure molecular diffusion (), pseudo-diffusion (*), and perfusion fraction ()-were quantified for commonly observed lesion types (2506 lesions from 224 patients with MS, excluding 13 patients due to MRI artifacts or not meeting the diagnostic criteria for RR-MS) and for corresponding brain regions in 29 healthy control participants. A one-way analysis of variance, followed by post-hoc analysis (Tukey's test), was performed to compare mean values between the healthy and MS groups. Receiver operating characteristic curve analyses, including area under the curve, sensitivity, and specificity, were conducted to determine the cutoff values of IVIM parameters for distinguishing between the groups. A -value of ≤0.05 and 95% confidence intervals were used to report statistical significance and precision, respectively. All IVIM parametric maps in this study discriminated among most MS lesion types. ADC, , and * values for MS black hole lesions were significantly higher ( < 0.0001) than those for other MS lesions and healthy controls. ADC, , and * maps demonstrated high sensitivity and specificity, whereas maps exhibited low sensitivity but high specificity. IVIM parameters provide valuable diagnostic and clinical insights by demonstrating high sensitivity and specificity in evaluating different categories of MS lesions.
多发性硬化症（MS）是一种慢性异质性疾病，其特征为脱髓鞘以及轴突丢失和损伤。磁共振成像（MRI）已被用于区分各种类型MS病变中的这些变化。我们旨在评估健康个体以及包括强化、非强化和黑洞病变在内的各种类型MS病变的不同脑区的体素内不相干运动（IVIM）扩散和灌注MRI指标。一项前瞻性研究纳入了237例MS患者（65例男性和172例女性）以及29名健康对照参与者（25例男性和4例女性）。场强为1.5特斯拉。成像序列包括三维（3D）T、三维液体衰减反转恢复、二维（2D）T加权成像以及二维扩散加权成像（DWI）序列。对常见病变类型（来自224例MS患者的2506个病变，排除13例因MRI伪影或不符合复发缓解型MS诊断标准的患者）以及29名健康对照参与者的相应脑区，对IVIM衍生参数——表观扩散系数（ADC）、纯分子扩散（）、伪扩散（）和灌注分数（）进行了量化。进行单因素方差分析，随后进行事后分析（Tukey检验），以比较健康组和MS组之间的平均值。进行了受试者操作特征曲线分析，包括曲线下面积、敏感性和特异性，以确定区分两组的IVIM参数的临界值。分别使用≤0.05的P值和95%置信区间来报告统计学显著性和精密度。本研究中的所有IVIM参数图在大多数MS病变类型之间具有鉴别能力。MS黑洞病变的ADC、和值显著高于（<0.0001）其他MS病变和健康对照。ADC、和*图表现出高敏感性和特异性，而图表现出低敏感性但高特异性。IVIM参数通过在评估不同类别的MS病变中表现出高敏感性和特异性，提供了有价值的诊断和临床见解。
