title: The contribution of diffusion-weighted MR imaging in multiple sclerosis during acute attack.
abstract: OBJECTIVE
  The aims of the study are firstly, to determine the difference in diffusion-weighted imaging (DWI) in normal appearing white matter (NAWM) between patients with acute multiple sclerosis (MS) and controls; secondly, to determine whether there is a correlation between EDSS scores and DWI in acute plaques and also NAWM.
  
  
  METHODS
  Out of 50 patients with acute MS attack, 35 patients had active plaques with diffuse or ring enhancement on postcontrast images. Eighteen healthy volunteers constituted the control group. While 26 of 35 had relapsing-remitting, 9 had secondary progressive MS. Apparent diffusion coefficients (ADC) of the active plaques, NAWM at the level of centrum semiovale and occipital horn of lateral ventricle in the patients and NAWM in control group were measured. ADC values of active plaques were compared with WM of the patients and the control group. The relationship of ADC value of active plaques and WM in MS with expanded disability status scale (EDSS) was investigated by using Mann-Whitney U-test.
  
  
  RESULTS
  Of 63 plaques totally, 26 and 37 of the active plaques had diffuse and ring enhancement, respectively. There was no statistically significant difference between ADC value of active plaques and EDSS (p>0.05). However, there was a statistically significant difference between ADC value of WM occipital horn and EDSS (p<0.05). ADC value of active plaques were higher than WM in both groups (p<0.001). The difference between ADC value of WM at the centrum semiovale (p<0.05) and occipital horns (p<0.001) in patients and controls was statistically significant. There was no statistically significant difference between EDSS scores, ADC value at centrum semiovale and WM around occipital horn and active plaques in subgroups (p>0.05).
  
  
  CONCLUSIONS
  Apparently normal tissue in MS patients may show early abnormalities when investigated carefully enough, and there is an even though moderate correlation between EDSS and ADC values and early alterations of ADC value are starting in the occipital white matter along the ventricles. This has to be verified in larger series.
authors.affiliation: Uludag University Medical School, Department of Radiology, Bursa, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Yurtsever
authors.forename: Bahattin
authors.initials: B
authors.lastname: Hakyemez
authors.forename: Ozlem
authors.initials: O
authors.lastname: Taskapilioglu
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Erdogan
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Turan
authors.forename: Mufit
authors.initials: M
authors.lastname: Parlak
mesh_terms: D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D018709:Statistics, Nonparametric