Aims and objectives
The term demyelination denotes loss of myelin with relative preservation of axons.
This results from diseases that either directly damage the myelin sheaths or damage the cells that form them.
Technological advances in recent years have dramatically improved our understanding of these diseases.
Magnetic Resonance Imaging (MRI) has become a critically important tool in the diagnosis and differentiation of different demyelinating disorders.
In this study,
we have focused on the three major inflammatory demyelinating diseases of the brain,
namely Multiple Sclerosis (MS),
Acute Disseminated Encephalomyelitis...
Methods and materials
Our descriptive cross sectional study was carried out over a period of two years.
40 consecutive patients presenting to our department for imaging with clinico-radiological features of inflammatory demyelinating diseases were recruited into the study.
Common demyelinating diseases were included in the study,
namely multiple sclerosis (Figure 1),
neuromyelitis optica (Figure 2),
acute disseminated encephalomyelitis (Figure 3) and the variants of multiple sclerosis (Figure 4) including radiologically isolated syndrome.
The demyelinating diseases were diagnosed according to the revised diagnostic criteria.
Clearance from the Institutional Ethics...
Results
A total of 40 subjects were analyzed with a total of 241 lesions on imaging being analyzed overall.
The age and sex distribution of the subjects were analyzed.
Majority of the patients in our study were in the age group of 21 to 40 years (45%).
Majority of the patients were female (23),
accounting for 57.5% of the subjects (Figure 9).
Among the total 40 subjects involved in the study,
24 were cases of MS,
14 were cases of ADEM,
and 2 were cases of...
Conclusion
DWI hyperintensity is highly sensitive in detecting active contrast enhancing lesions (100% in our study).
However the specificity is lower because of some false positives.
But it can be used as a sensitive screening test with a high negative predictive value for identification of active lesions in cases where administration of contrast is not possible or poses significant risk to the patient,
as it can effectively obviate the need for contrast administration in such cases.
True diffusion restriction has a high specificity for the detection...
Personal information
Manohar Kumar
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
Rupie Jamwal
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
Venkatram Krishnan
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
References
Swanton JK,
Rovira A,
Tintore M,
Altmann DR,
Barkhof F,
Fillippi M et al.
MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study.
Lancet Neurol.
2007;6:677-86.
Polman CH,
Reingold SC,
Edan G,
Fillippi M,
Hartung HP,
Kappos L et al.
Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria.” Ann Neurol.
2005;58:840-46.
Young NP,
Weinshenker BG,
Lucchinetti CF.
Acute Disseminated Encephalomyelitis: Current Understanding and Controversies.
Semin Neurol.
2008;28:84-94.
Wingerchuk DM,
Lennon PVA,
Pittock SJ,
Lucchinetti CF,...