ABSTRACT

To determine the value of magnetization transfer (MT) imaging in the evaluation of acute plaques, which cause clinical findings in the brain magnetic resonance (MR) images of patients with relapsing-remitting multiple sclerosis, and its correlation with the clinical findings.

Forty patients with relapsing-remitting multiple sclerosis were included in the study. They were being followed-up for the diagnosis of relapsing-remitting multiple sclerosis based on McDonald?s criteria. To evaluate the acute plaques of the patients, their T1- weighted spin echo sequences were divided into 3 groups: precontrast and postcontrast MT images (group 1), postcontrast MT images only (group 2), and precontrast and postcontrast non-MT images (group 3). The sensitivity and positive predictive values were calculated to determine the correlation between the patients considered to have had attacks and the acute plaques detected during MR imaging examinations with T1-weighted spin echo.

After clinical examinations, in 25 of 40 patients (62.5%), there were neurological findings suggesting acute attacks. Among the 3 imaging groups, there was a significant difference in the number of acute plaques. In group 1 there were a total 30 findings suggesting acute plaques; in group 2 33; and in group 3 there were 20. When the correlation between the patients who were considered to have had attacks after their clinical examinations and the acute plaques detected with T1- weighted spin echo examinations were evaluated, the sensitivity and positive predictive values were 97% and 100% in group 1, 87% and 78% in group 2, and 65% and 100% in group 3, respectively.

In MS, T1-weighted MT examinations yield more reliable results for following up the treatment and changes in the development of the disease. They also offer a more effective evaluation of the acute plaques that cause clinical findings.

Keywords: multiple sclerosis, brain, magnetic resonance imaging, magnetization transfer