Role of Susceptibility Weighted Imaging in Evaluation of Patients with Multiple Sclerosis | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 101, Issue 1, October 2025, Pages 5265-5275 PDF (736.03 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.461098 | ||
| Abstract | ||
| Background: Multiple Sclerosis (MS) is an inflammatory autoimmune disease involving multifocal demyelination and neuronal loss. Routine MRI detects lesions, yet newer modalities like Susceptibility-Weighted Imaging (SWI) offer insight into vascular and iron pathology. Aim: This study aimed to determine the utility of SWI in the detection of signs of CVS and PRL in patients with MS, and its comparison with 3D FLAIR for lesion detection. Methods: A prospective study included 50 clinically confirmed MS patients (age 11–52 years) who underwent standard MRI, supplementary 3D FLAIR, and SWI. Fifteen participants also received contrast-enhanced T1 imaging. Lesions were evaluated for total count, CVS, and paramagnetic rim lesion (PRL) presence. Sensitivity and lesion characteristics of 3D FLAIR and SWI were contrasted, and correlations with patient age and lesion burden were computed Results: 3D FLAIR detected a slightly larger total number of lesions (1,084 vs. 1,050) and median number of lesions per patient (25 vs. 20; p = 0.004). SWI demonstrated superior detection of CVS-positive lesions (median 9.5 vs. 3.5; p < 0.001), with CVS in 90% and PRLs in 74% of subjects. SWI alone detected iron-related pathology and vascular involvement, contributing to lesion count provided by 3D FLAIR. Conclusion: SWI augments conventional MRI in MS evaluation with added specificity through CVS and paramagnetic rim depiction, echoing vascular and chronic inflammation activity. Synthesis of 3D FLAIR for lesion load and SWI for iron- and vein-related observations optimizes diagnosis and prediction assessment, making routine incorporation of SWI in MS imaging protocols a preferred option. | ||
| Keywords | ||
| Multiple sclerosis; Susceptibility-weighted imaging; SWI; 3D FLAIR; Central vein Sign; Paramagnetic rim lesions | ||
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