Comparison between diffusion-weighted imaging and post-contrast enhanced T1-weighted sequence in brain MRI of patients with an acute attack of multiple sclerosis and the role of serum vitamin D3 level in its diagnosis
Abstract Background and purpose. – Identifying multiple sclerosis (MS) lesions is cornerstone in the diagnosis and prognosis of the disease activity. Application of contrast-enhanced magnetic resonance imaging (CE-MRI) is vital but the alternative use of diffusion-weighted imaging (DWI) and biomarkers is most appropriate when the injection of contrast agents is contraindicated. The present study investigated the possible substitution of CE-MRI with DWI and determined a vitamin D3 cutoff point for MS patients with positive MRI.Materials and Methods. – 5 ml of peripheral venous blood was collected from all patients and DWI and post-contrast T1-weighted MRI were performed on 85 patients with acute attacks of MS from April 2018 to November 2019. Contrast-enhanced lesions were considered the gold standard of activity in MRI in evaluating the relation between CE-MRI and DWI.Results. – The accuracy of CE-MRI was higher (63.5%) compared to DWI (27.1%). Majority of patients (54) showed positive results in CE-MRI. The difference between patients with and without positive CE-MRI was statistically significant in terms of vitamin D3 deficiency (P=0.001). The optimal cutoff of vitamin D3 for CE-MRI positive patients was 23.33 ng/ml with 83.33% sensitivity and 61.29% specificity. Conclusions. – Combination of CE-MRI and DWI yields more positive imaging results; DWI sequence alone, without using T1 with contrast in MRI, is not enough to assess brain lesion activity in patients with MS. Furthermore, vitamin D3 levels of <23.33 ng/ml correlate well with a positive result in CE-MRI where the MS activity is most likely to be present..
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Preprint| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
ResearchSquare.com - (2022) vom: 01. Juli Zur Gesamtaufnahme - year:2022 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nazeri, Masoume [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-1656385/v1 |
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| PPN (Katalog-ID): |
XRA036416096 |
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| 520 | |a Abstract Background and purpose. – Identifying multiple sclerosis (MS) lesions is cornerstone in the diagnosis and prognosis of the disease activity. Application of contrast-enhanced magnetic resonance imaging (CE-MRI) is vital but the alternative use of diffusion-weighted imaging (DWI) and biomarkers is most appropriate when the injection of contrast agents is contraindicated. The present study investigated the possible substitution of CE-MRI with DWI and determined a vitamin D3 cutoff point for MS patients with positive MRI.Materials and Methods. – 5 ml of peripheral venous blood was collected from all patients and DWI and post-contrast T1-weighted MRI were performed on 85 patients with acute attacks of MS from April 2018 to November 2019. Contrast-enhanced lesions were considered the gold standard of activity in MRI in evaluating the relation between CE-MRI and DWI.Results. – The accuracy of CE-MRI was higher (63.5%) compared to DWI (27.1%). Majority of patients (54) showed positive results in CE-MRI. The difference between patients with and without positive CE-MRI was statistically significant in terms of vitamin D3 deficiency (P=0.001). The optimal cutoff of vitamin D3 for CE-MRI positive patients was 23.33 ng/ml with 83.33% sensitivity and 61.29% specificity. Conclusions. – Combination of CE-MRI and DWI yields more positive imaging results; DWI sequence alone, without using T1 with contrast in MRI, is not enough to assess brain lesion activity in patients with MS. Furthermore, vitamin D3 levels of <23.33 ng/ml correlate well with a positive result in CE-MRI where the MS activity is most likely to be present. | ||
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