The use of DIR and SWI sequences in 1.5 Tesla MRI for the diagnosis of multiple sclerosis

Background Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system, characterized by demyelination and neurodegeneration. Accurate diagnosis, especially in atypical cases, relies heavily on imaging techniques. This study evaluates the sensitivity of DIR (double inversion recovery) and SWI (susceptibility-weighted imaging) sequences in detecting MS plaques and central venous signs (CVS) using 1.5 Tesla MRI. Methods Seventeen patients with confirmed MS were enrolled after excluding other comorbidities. Brain MRI was performed using T2, FLAIR, SWI, and DIR sequences. Plaques were counted in cortical/juxtacortical, subcortical, periventricular, and infratentorial regions. The presence of CVS was assessed in SWI and FLAIR sequences. Statistical analyses were conducted using SPSS26. Results A total of 1022 plaques were identified, with DIR showing the highest sensitivity (321 plaques), followed by FLAIR (278), SWI (219), and T2 (204). The periventricular and subcortical regions were the most common sites of plaque detection across all sequences. DIR showed a 13%, 32%, and 36% higher sensitivity than FLAIR, SWI, and T2, respectively. CVS was most prominent in the SWI sequence (52.5% of plaques) compared to FLAIR (6%). DIR and T2 sequences showed negligible sensitivity for CVS detection. A significant association was found between age and the prevalence of CVS in the infratentorial region. Conclusion DIR is the most sensitive sequence for detecting MS plaques, particularly in the periventricular and infratentorial regions. SWI at 1.5 Tesla MRI demonstrates a high prevalence of CVS and can differentiate MS from other pathologies. Further studies are warranted to confirm these findings in larger populations.