Demonstration of Restricted Diffusion Early in the Development of Inflammatory/Demyelinating Lesions - A Multiparametric MR Study

MATERIALS and METHODS Two patients were studied serially: (A) a 19 year old man with clinically definite MS and (B) a 30 year old woman with probable MS (previous episode of optic neuritis 3 months earlier) who both presented with clinical relapses ((A) right hemiparesis; (B) hemianopia, left hemiparesis)). They were studied over 4 months with MRI (on days: (A) 0, 2, 5, 7, 10, 12, 18, 20, 25, 62, 85, 115; (B) 0, 5, 7, 11, 16, 23, 33, 65, 93, 121) and volume selective MR 1H spectroscopy @IRS) (3 studies each): 1. a) Proton density-, Tz-, Tr-weighted, b) isotropic diffusionweighted (DW) EPI (5 b values=O-1000s/mm2), c) Magnetisation Transfer Ratio (MTR) (FLASH 3D, 40 ms/ 5 ms/ FLIP 12 O), d) Ti-weighted 5 and 15 minutes after 0.2 mmol/kg (“double dose“) Gadodiamid-DTPA. 2. MRS (TR 1500 ms/TE lo+135 ms, 2 cm”)