The Role of Dynamic Susceptibility Contrast Perfusion Magnetic Resonance Imaging in the Evaluation of Active and Inactive Demyelinating Plaques in Multiple Sclerosis

Aim: Our goal in this study was to find out if active plaques that exhibiting enhancement and inactive plaques that do not differing in dynamic-susceptibility-contrast perfusion-weighted-imaging (DSC-PWI)DSC-PWI measures in multiple sclerosis (MS) patients. Material and Methods: In our study, DSC-PWI mDynamic susceptibility contrast perfusion-weighted agnetic resonance imagingMRI (DSC-PI) (MRI) examinations of 30 patients diagnosed with Multiple Sclerosis were retrospectively analyzed. A region of interest (ROI) was manually drawn on DSC-PWI between active plaques that showing ed enhancement on conventional MRI sequences and inactive plaques that did not showing enhancement. Cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) in this ROI were also recorded. These measurements were also normalized to apparently unaffected contralateral white matter hemisphere measurements. These normalized values were named relative (rCBV), rCBF, rMTT, and rTTP. Results: Both rCBV and rCBF were significantly higher in active demyelinating plaques compared to chronic demyelinating plaques (p<0.001). Mean rCBV and rCBF values in active plaques were 1.61 ± 0.66 and 1.44 ± 0.59, respectively. In chronic plaques, the mean rCBV was 0.91 ± 0.32 and the mean rCBF was 0.81 ± 0.26. The mean rMTT was 0.98 ± 0.53 in active demyelinating plaques and 1.30 ± 0.44 in chronic demyelinating plaques and there was a significant difference between the two groups (p=0.004). Mean rTTP was also significantly prolonged in active demyelinating plaques compared to chronic plaques (p<0.001). Mean rTTP was 0.93 ± 0.14 and 1.06 ± 0.21 in active and chronic demyelinating plaques, respectively. Conclusions: In conclusion, the DSC-PWI examination may provide reliable information in the evaluation ofactive and inactive demyelinating plaques in MS.