OVIDIUS UNIVERSITY OF CONSTANA

FACULTY OF MEDICINE

MEDICAL IMAGING
OF DEMYELINATING DISEASES; WITH
EMPHASIS ON MULTIPLE SCLEROSIS

Thesis Presentation by :Anis Ettehadulhagh

SCIENTIFIC COORDINATOR: Dr. Baz
Radu-Octavian

DEFINITION

A demyelinating disease is any disease affecting the

central nervous system, which results in damage to the
myelin sheath of neurons.
Multiple sclerosis (MS), is an inflammatory disease in which
the insulating covers of nerve cells in the brain and spinal cord
are damaged. This damage disrupts the ability of parts of the
nervous system to communicate.

MRI used to investigate the body in both health and disease.

It uses magnetic fields and radio waves to form images of
the body , widely used for medical diagnosis, staging of
disease and follow-up without exposure to ionizing radiation.

MATERIAL AND METHOD

- 5 patients from Constanta, Romania :

- 2 Male, 3 Female
- Age range: 26-47
- Method of Investigation: MRI (T1-T2 Sequencing)
- Gadolinium enhancement
Purpose was to appreciate the diagnosis and follow-up,
by way of medical imaging, of these multiple sclerosis patients
.

SPINAL LESIONS
Fig.1 Sagittal plane image,
highlighting hyperintense
lesions, visible in spinal
area, in 47 year old female
patient.

SPINAL LESIONS

Fig.2 35 year old male in

question. Note spinal
hyperintense lesions.

DAWSONS FINGERS
The McDonald s Criteria, which show radiologic evidence of lesions at different
times and in different areas, is the most commonly used method of diagnosis.
One of the most important signs of the McDonalds Criteria include ;
Dawson's fingers ; features depicting demyelinating plaques through the
corpus callosum, arranged at right angles along medullary veins

Fig. 3 Dawsons Fingers clearly visible in pericalossal area

DAWSONS FINGERS

Fig.4 : T2 axial plane image, showing white

matter lesions, in 35 year old male patient. Note
the visible presence of Dawsons Fingers.

DISSEMINATION IN SPACE
Another imaging criterion for the diagnosis of MS ; Dissemination in Space

Fig.5: Visible dissemination in space, in 43 year old female patient.

Another imaging criterion for the diagnosis

of MS ; Dissemination in Time

Fig. 6 MS progression as seen

over 4 years. Note the
disseminations in time

Generalized Inflammatory Activity

Fig.7: Multiple enhancing lesions in 26 year old male.

Showing Gadolinium enhancement

Generalized Inflammatory Activity

Fig 8 : lesions in generalised white and grey matter

(Diffusion ).

CONCLUSION
MRI technique remains the best imagistic method to positively
diagnose MS, better than CT scan or any other radiological
tool.Because :
-Minimal ionizing radiation unlike X-ray thereby making it safe
for pregnant patients
-Increased detailed diagnostic imagistic information otherwise
unavaliable using other methods
-Best in detecting dissemination in time especially using
gadolinium enhancement
Due to the above advantages of MRI imagistic use
the diagnosis of MS has increased within recent past, this
in spite of the fact that MS signs and symptoms are very
similar to those of other demyelinating diseases.
The patients of Constanta, Romania for the past 2.5 years have
been receiving optimal treatment, follow-up and accompaniment,
due to detailed and accurate imaging of the progression of their
disease.

THANKS FOR YOUR

TIME AND ATTENTION