Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disease of the central nervous system (CNS). MS diagnosis and disease monitoring are mostly based on Magnetic Resonance Imaging (MRI). This study aims to compare a double inversion recovery MRI sequence with a fluid-attenuated inversion recovery sequence in Multiple Sclerosis (MS) in the brain. A study was conducted on 75 patients whose aged between 10 and 70 years who were having MS in the brain to compare a double inversion recovery DIR sequence with a fluid-attenuated inversion recovery FLAIR sequence at King Salman Specialist Hospital. in this study the age group (30-49) and female patient represented the highest percentage (69%) and (60%) respectively, A correlation between DIR and FLAIR in terms of the number of MS lesions and mean ±SD was found. DIR detected a higher total number of MS lesions in 75 patients tested (a total of 1886 MS lesions were detected in DIR compared to 1723 MS lesions in FLAIR). FLAIR imaging showed higher rates of periventricular lesions (a total of 508 lesions, the Mean ±SD was 9.5± 9.5) than DIR imaging (a total of 423 lesions, the Mean ± SD was 9.0± 9.0), statistically significant (p = 0.007). The DIR sequence detected a higher total number of MS lesions than the FLAIR sequence, while the FLAIR sequence is better at detecting periventricular lesions. There was no statistically significant relationship between the patient’s age groups and the number of lesions in DIR and FLAIR P-value > 0.05.
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