Characterization of multiple sclerosis lesions with the inclusion of susceptibility weighted imaging on a 3T MRI scanner in Sri Lankan patients

Abstract

Background: Multiple sclerosis (MS) is an under-researched disease in Sri Lanka. Detailed MRI analysis of MS has become possible with the availability of high resolution 3T scanners in the country. Objectives: To describe the MRI features of MS in Sri Lankan patients and to identify the sensitivity of the Central Vein Sign at 3T. Methods: A descriptive cross-sectional study was conducted on MS patients presenting for MRI at National Hospital of Sri Lanka, Colombo over a 12-month-period. Imaging was performed on a 3T MRI scanner and interpreted on digital format. Results: The mean age of symptom onset was 30 years and the male to female ratio was 1:1.6. Periventricular lesions were found in the most patients (98.9%, n=91). Spinal cord lesions were found in 88.0% (n=81) and all these patients showed cervical cord involvement. Contrast enhancement was identified in 24% (n=22) indicating active lesions. A vast majority of lesions showed normal or increased diffusivity (97.8%, n=90). Nearly all the patients had positive central vein sign (98.9%, n=91) and most were periventricular (73.6%, n=502). Mean CVS positivity was 7.41. Optic neuritis was identified in 42.4% (n=39) and unilateral short segment (97.4%, n=38) optic neuritis was the commonest pattern. Conclusions: Demography and MRI morphology of the Sri Lankan MS patients are similar to that of the Western populations. Identifying the CVS at 3T MRI is feasible and we recommend it to be included in routine MS reporting.

Keywords

• multiple sclerosis
• central vein sign