Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

BACKGROUND: Diagnosis of multiple sclerosis is based on multiple clinical, laboratory and imaging tests among which MRI stands as the modality of choice between the imaging techniques. Conventional MRI provides important morphologic information regarding the brain and spinal cord involvement by demyelinating plaques. However, it is of almost no value in assessing the normal appearing white matter which have been proved by multiple pathologic studies to be directly and indirectly involved in the process of multiple sclerosis. Diffusion Weighted Imaging and Diffusion Tensor-MRI have been widely used in multiple researches as a better solution for studying the normally appearing white matter. OBJECTIVE: To evaluate the role of Diffusion Tensor Imaging in the examination of the brain and spinal cord white matter that shows normal appearance on conventional MRI sequences in patients with multiple sclerosis. DESIGN: Prospective randomized cross sectional study. PATIENTS and METHODS: Fifty right handed clinically, laboratory and radiologically diagnosed patients with multiple sclerosis (25 patients with relapsing remitting and 25 with secondary progressive multiple sclerosis). Another group of twenty five normal individuals were taken as control and were submitted for the same examination protocol and post processing analysis. OUTCOME: Changes in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were examined and correlated with the morphologic changes detected on conventional MR imaging on one hand and the clinical status on the other hand

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