Diffusion-weighted imaging helps differentiate multiple sclerosis and neuromyelitis optica-related acute optic neuritis

J Magn Reson Imaging. 2017 Jun;45(6):1780-1785. doi: 10.1002/jmri.25528. Epub 2016 Nov 9.

Abstract

Purpose: To evaluate the apparent diffusion coefficient (ADC) values between multiple sclerosis (MS) and neuromyelitis optica (NMO)-related acute optic neuritis (ON) patients and predict their optic nerve atrophy of optic coherence tomography (OCT) parameters.

Materials and methods: Nineteen MS and 15 NMO-related acute ON patients who underwent a diffusion-weighted imaging sequence in 3.0 Tesla MR scanner and a follow-up OCT examination after 6 months were included. The ADC values, thickness of the retinal nerve fiber layer (RNFL) and the macular ganglion cell complex (GCC) between MS and NMO related ON were assessed.

Results: The mean ADC value of the NMO-ON, (0.691 ± 0.195[SD]) × 10-3 mm2 /s, was significantly smaller (P = 0.0133) than that of MS-ON. The mean ADC value of MS-ON, (0.879 ± 0.144) × 10-3 mm2 /s, was significantly smaller (P < 0.0001) than that of control group, (1.025 ± 0.067) × 10-3 mm2 /s. Using an ADC value smaller than 0.830 × 10-3 mm2 /s as the threshold value for differentiating MS-ON from NMO-ON patients, the highest accuracy of 76.7%, with 75.0% sensitivity and 78.3% specificity, was obtained. The ADC value measured at the acute stage of ON was correlated with the thickness of the RNFL (r = 0.441; P = 0.006) and the GCC (r = 0.526; P < 0.0001) after 6 months.

Conclusion: The ADC value might be helpful for differentiating MS-ON from NMO-ON patients. The decreased ADC value was correlated with optic nerve atrophy on OCT.

Level of evidence: 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1780-1785.

Keywords: diffusion weighted imaging; multiple sclerosis; neuromyelitis optica; optic neuritis.

MeSH terms

  • Acute Disease
  • Adult
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Multiple Sclerosis / diagnostic imaging*
  • Multiple Sclerosis / pathology
  • Neuromyelitis Optica / complications
  • Neuromyelitis Optica / diagnostic imaging*
  • Neuromyelitis Optica / pathology
  • Observer Variation
  • Optic Nerve / diagnostic imaging*
  • Optic Nerve / physiology
  • Optic Neuritis / complications
  • Optic Neuritis / diagnostic imaging*
  • Optic Neuritis / pathology
  • Reproducibility of Results
  • Sensitivity and Specificity