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Article Type

Research Paper

Abstract

Differentiating acute ischemic stroke from active multiple sclerosis (MS) plaques using conventional MRI can be challenging due to overlapping radiological features. The Apparent Diffusion Coefficient (ADC) provides a quantitative measure of water diffusion, potentially offering a solution to this diagnostic dilemma. This study aims to evaluate the role of ADC value measurements in distinguishing between acute ischemic stroke and acute demyelinating MS lesions. This cross-sectional study was conducted at a tertiary care center in Iraq from November 2024 to July 2025. All participants underwent a standardized brain MRI protocol on a 1.5-T scanner. ADC values were measured by manually placing regions of interest (ROIs). A total of 50 patients were enrolled: 20 with ischemic stroke and 30 with MS. The mean ADC value for acute ischemic lesions (373.8 ± 147.6 × 10⁻⁶ mm²/s) was significantly lower than that for acute demyelinating lesions (1209.0 ± 337.4 × 10⁻⁶ mm²/s) (P < 0.001). Chronic ischemic lesions exhibited the highest ADC values (1899.6 ± 336.2 × 10⁻⁶ mm²/s), which were significantly greater than those of chronic demyelinating plaques (997.6 ± 386.8 × 10⁻⁶ mm²/s) (P = <0.001). ADC values also effectively distinguished acute from chronic ischemic lesions (P < 0.001). This study found the quantitative ADC measurement is a highly reliable tool for differentiating acute ischemic stroke from active MS plaques. The profound restriction in acute ischemia contrasts sharply with the elevated diffusivity in acute demyelination. Establishing ADC thresholds can significantly enhance diagnostic accuracy, guide appropriate therapeutic intervention, and prevent mismanagement in a clinical setting.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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