{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T11:49:20Z","timestamp":1789213760848,"version":"build-2803163510"},"reference-count":55,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Salman Center For Disability Research","award":["KSRG-2024-197"],"award-info":[{"award-number":["KSRG-2024-197"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Multiple sclerosis (MS) is a chronic and heterogeneous disease characterized by demyelination and axonal loss and damage. Magnetic resonance imaging (MRI) has been employed to distinguish these changes in various types of MS lesions. Objectives: We aimed to evaluate intravoxel incoherent motion (IVIM) diffusion and perfusion MRI metrics across different brain regions in healthy individuals and various types of MS lesions, including enhanced, non-enhanced, and black hole lesions. Methods: A prospective study included 237 patients with MS (65 males and 172 females) and 29 healthy control participants (25 males and 4 females). The field strength was 1.5 Tesla. The imaging sequences included three-dimensional (3D) T1, 3D fluid-attenuated inversion recovery, two-dimensional (2D) T1, T2-weighted imaging, and 2D diffusion-weighted imaging (DWI) sequences. IVIM-derived parameters\u2014apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), and perfusion fraction (f)\u2014were quantified for commonly observed lesion types (2506 lesions from 224 patients with MS, excluding 13 patients due to MRI artifacts or not meeting the diagnostic criteria for RR-MS) and for corresponding brain regions in 29 healthy control participants. A one-way analysis of variance, followed by post-hoc analysis (Tukey\u2019s test), was performed to compare mean values between the healthy and MS groups. Receiver operating characteristic curve analyses, including area under the curve, sensitivity, and specificity, were conducted to determine the cutoff values of IVIM parameters for distinguishing between the groups. A p-value of \u22640.05 and 95% confidence intervals were used to report statistical significance and precision, respectively. Results: All IVIM parametric maps in this study discriminated among most MS lesion types. ADC, D, and D* values for MS black hole lesions were significantly higher (p &lt; 0.0001) than those for other MS lesions and healthy controls. ADC, D, and D* maps demonstrated high sensitivity and specificity, whereas f maps exhibited low sensitivity but high specificity. Conclusions: IVIM parameters provide valuable diagnostic and clinical insights by demonstrating high sensitivity and specificity in evaluating different categories of MS lesions.<\/jats:p>","DOI":"10.3390\/diagnostics15101260","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T09:58:27Z","timestamp":1747303107000},"page":"1260","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Investigating the Role of Intravoxel Incoherent Motion Diffusion-Weighted Imaging in Evaluating Multiple Sclerosis Lesions"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-2514","authenticated-orcid":false,"given":"Othman I.","family":"Alomair","sequence":"first","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"},{"name":"King Salman Centre for Disability Research, Riyadh 11614, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6404-8762","authenticated-orcid":false,"given":"Sami A.","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6608-6922","authenticated-orcid":false,"given":"Abdullah H.","family":"Abujamea","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, King Saud University Medical City & College of Medicine, King Saud University, Riyadh 7805, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Y.","family":"AlfIfi","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"},{"name":"Radiology Department, Maternity and Children\u2019s Hospital in Dammam Eastern Health Cluster, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0857-524X","authenticated-orcid":false,"given":"Yazeed I.","family":"Alashban","sequence":"additional","affiliation":[{"name":"Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6340-182X","authenticated-orcid":false,"given":"Nyoman D.","family":"Kurniawan","sequence":"additional","affiliation":[{"name":"Centre for Advanced Imaging, Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/ene.13819","article-title":"Multiple sclerosis\u2014A review","volume":"26","author":"Dobson","year":"2019","journal-title":"Eur. J. 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