The Role of MRI in the Early Detection of Multiple Sclerosis.

Background: Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the CNS and the most frequent cause of nontraumatic neurological disability in young and middle-aged adults (1). Women are twice as likely to be affected as men, and onset typically occurs between the ages of 20 and 40 years (2). The diagnosis Depend on a detailed history; careful neurological examination; and supportive paraclinical investigations. According to the new McDonald criteria, the diagnosis of MS requires objective evidence of lesions disseminated in space and time.MRI findings may contribute to the determination of dissemination in time or space (4). Aim of the study: the aim is to evaluate the role of MRI and find the most common findings in the early stages of the disease,which could provide the knowledge to help finding a higher quality care or even a cure to the disease. Methodology: This retrospective descriptive study was conducted at security forces hospital, Riyadh city, kingdom of Saudi Arabia. Data was collected by chart and radiological images review of all patients from any age or gender who were 1st diagnosed with multiple sclerosis by MRI. From 01-01-2013 till 01-01-2016 to evaluate the MRI role and to find what are the most common MRI findings of multiple sclerosis in early stages of the disease. Results: We have found that the MRI is the first choice of imaging in detecting Multiple Sclerosis. From our 50 patients 15(30%/) were diagnosed by active demyelinating MS and 35 patients (70%) were diagnosed by chronic demyelinating MS. The most used sequence in all the cases was T2 weighted, FLAIR was performed in 49 of the cases (98%), T1 after IV contrast was used in 7 cases (14%). The common findings in the chronic demyelinating MS were high signal intensity in T2 weighted and in Axial FLAIR, in active demyelinating MS was characterized by enhancement after IV contrast and restricted diffusion. Conclusion: Most common technique for detecting MS in the early stages is Multiplanar Multisequential technique, we have found that the most common findings in Chronic multiple sclerosis are high signal intensity on T2 weighted images and flair and the active multiple sclerosis is represented by high enhancement after administration of IV contrast and in some cases, restricted diffusion is considered a sign of activity. MRI is in fact the most sensitive modality to detect MS at early stages.