Abstract

Background: Demyelinating disorders are a heterogeneous group of diseases described as centralwhite matter disease, in which myelin loss exceeds axonal loss. The result of demyelinating diseasesis the thinning or even focal disappearance of the myelin sheath of axons. Such changes will affectsignal propagation in affected axons; depending on their location, this can lead to a host of neurologicandpsychiatric symptoms.

Aim of the study: To analyze the practical approach of MRI in white matter diseases of adult brain.

Objectives of the study: To study the distribution and nature of MRI findings in white matter diseases of adult brain and to establish an accurate diagnosis and to narrow down the differential diagnosis in various white matter diseases.

Materials and methods: The present study was conducted in the Department of Radiology, Great Eastern Medical College Srikakulam for a period of 12 months from August 2020 toJuly2021. It was an observationalstudy involving 50 cases, who were above 14 years of age with clinical suspicion / diagnosis of whitematter lesion, referred to the Department of Radiology for MRI irrespective of sex. Patients withclinical suspicion / diagnosis of white matter lesion referred to MRI with age more than 14 years andof both sexes, both out patients and in patients were included in the study. Exclusion criteria were patients with MRI non-compatible implants in their body in any form (pacemaker, orthopedic implants etc., patients with claustrophobia, unstable patients on life support mechanism, patients notwilling to give the consent and all the patients with age related vascular causes were not included inthestudy.

Results: The present study had been carried out for a period of 12 months among 50 adult patients aged 15 years and above who were referred for MRI to the department of Radio diagnosis, with clinical suspicion or diagnosis of white matter disease. 62% of the study population belonged to the age group of 15 to 34 years. There after a decreasing trend of the white matter lesions was observed with increase in age. Out of 50, only 2 cases (4%) belonged to age 65 years and above. Out of 50 cases studied, 27 (54%) were females and23 (46%) were males. Out of the total 50 cases studied, majority of the cases were of ADEM (28%)followed by PRES (20%). 5 cases each of ODM, MS and DAI were seen (10% each). 3 cases (6%) ofCADASIL,2 cases (4%) eachofTDM, PML, CTXand MBDwereobserved.

Conclusion: MRI due to its excellent gray-white matter resolution is very sensitive in detecting subtlewhite matter changes. The present study concludes that MRI, in correlation with DWI, MRS, MRcontrast in required cases is an ideal modality in early diagnosis of white matter diseases and aids intheearlyinstitutionof therapyso that the curable conditionsamongthemcan betreated.

Keywords: MRI;White matter; Brain