الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 73 |  |  |
| | | from | 73 | | |
Abstract
Multiple sclerosis (MS) is considered the most common an inflammatory autoimmune demyelinating disease of the central nervous system and may be the leading cause of disability among adults. Conventional MRI is still the method of choice for the initial assessment of patients suspected to have multiple sclerosis, because of its wide availability and its excellent sensitivity to display the plaques which are found throughout the brain and spinal cord in both gray and white matter. Substantial effort has been made to evaluate various changes that may be subtle or even not detectable in the normal appearing white matter (NAWM) by the conventional MRI.
This illustrates the demand for functional modalities like diffusion weighted magnetic resonance imaging (DWI) or MR spectroscopy. All these modalities have been used for the assessment of the NAWM alterations in peri-palque regions to detect microstructural changes.
Diffusion-weighted MR imaging is an important tool in the evaluation of the random molecular motion of water protons. The trace apparent diffusion coefficient (ADC) provides a rotationally invariant measurement of the total diffusion of water within a tissue. Diffusion-weighted MR imaging offers an opportunity to evaluate the structural characteristics of tissues. White matter is composed of highly organized myelinated axons that create an anisotropic restriction of water diffusion. Therefore, any process that results in changes in the structural elements of tissue may also affect its diffusion characteristics.
So, this study will be conducted to evaluate the NAWM in patients having MS by measuring the ADC value in it compared to the ADC value in the NAWM in normal control subjects.
Ten patients and ten control subjects primarily screened by MRI were enrolled in this study. This group of patients was 7 females and 3 males with a mean age 30 years (range21-44 years) compared to a control group of 10 normal individuals were 7 females and 3 males with a mean age 34years (range18-49 years).
All patients were subjected to the following:
o History taking with special emphasis on time of onset of symptoms and history of multiple sclerosis as well as allergy to contrast agents.
o Thorough clinical examination.
o Non contrast MRI brain at the time of admission followed by post intravenous contrast with gadolinium.
o Diffusion weighted MRI/ADC map.
The current study, showed the comparison between patients and control group regarding ADC in NAWM, in patients group ADC in NAWM was ranged from 762.8- 870.96 with a mean of 835.93±50.20, while the control group it ranged from 677.3 - 711.6 with a mean of 702.95±11.85, it was found that there was a significant increase in ADC in NAWM in patients more than the control group.