Husam S. Mourad¹, Al-Metwally A. Youssof¹, Hassan Elkiki²

Departments of Neurology¹, Radiology², Cairo University; Egypt.

Background: MS is a chronic demyelinating disease of the central nervous system. Conventional MR imaging readily identifies the classic hallmarks of MS in white matter yet has distinct disadvantages DTI is a powerful non-invasive technique for exploring cerebral ultrastructure. Objective: To investigate the microstructural changes in the cerebral white matter (WM), as measured by diffusion tensor imaging (DTI) in patients with relapsing remitting multiple sclerosis (MS) and secondary progressive MS. Methods: Twenty Egyptian patients diagnosed with multiple sclerosis. 10 patients relapsing remitting form (RRMS) and 10 patients secondary progressive form (SPMS). All patients were subjected to: complete general and neurological examination, routine laboratory investigations. Expanded Disability Status Scale (EDSS) and brain MRI that included in addition to the conventional MR sequences DTI sequence and ADC map. Results: SPMS and RRMS had significant elevated ADC and reduced FA in MS lesions than in mirror image NAWM. SPMS showed significantly elevated ADC and reduced FA than in NAWM. NAWM in SPMS showed a significant reduction FA values than in RRMS. Conclusion: SPMS had a significantly elevated ADC values and reduced FA values than in RRMS, revealing different pathologies in different MS phenotypes. DTI can provide further anatomic insights into mechanisms of white matter damage and may also increase its specificity in the monitoring of specific neurologic deficits in MS. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(4): 329-334]

Key Words: Multiple sclerosis, DTI, ADC, FA & NAWM.