Keywords:
Neuroradiology brain, CNS, MR, MR-Diffusion/Perfusion, Diagnostic procedure, Comparative studies, Inflammation
Authors:
M. Kumar1, R. JAMWAL2, V. Krishnan3; 1New Delhi/IN, 2NEW DELHI, DELHI/IN, 3New Delhi, Tamil Nadu/IN
DOI:
10.26044/ecr2019/C-0888
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 of active lesions (100% in our study).
However,
it has low sensitivity due to many false negatives and cannot replace CE T1WI for identification of active lesions.
In cases where administration of contrast is absolutely contraindicated,
true diffusion restriction can be used for identification of active lesions,
albeit with low sensitivity.
The results are more promising for multiple sclerosis than for other inflammatory demyelinating diseases.
Hence we conclude that DWI can act as a good surrogate marker for active lesions in inflammatory demyelinating diseases in cases where contrast administration is not advisable.