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Magnetization transfer imaging of patients with definite MS and negative conventional MRI
M Filippi1, M A Rocca, L Minicucci
1Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
Objective:
To assess, in a group of patients with clinically or laboratory-supported definite MS and negative conventional MRI scans of the brain, whether magnetization transfer imaging (MTI) is able to detect subtle white matter changes.
Background:
MTI of the brain in patients with MS frequently demonstrates the presence of microscopic damage to white matter, which appears normal on conventional MRI.
Methods:
Brain MRI and MTI scans were obtained from 11 patients with negative conventional MRIs of the brain, selected from 618 clinically or laboratory-supported definite MS cases scanned in the last 2 years in three Italian MS centers.
Results:
Compared with control subjects, patients had significantly lower mean MT ratios (MTR) in the pons, cerebellum, and periventricular regions. The percentages of pixels with MTR values below 1, 2, and 3 SD of the mean MTR value of the control subjects were 7.6% (range, 3.2% to 11.8%), 5.2% (range, 2.0% to 8.5%), and 3.6% (range, 1.2% to 6.1%), respectively. They were mainly located in the white matter of the centra semiovalia, and usually were isolated.
Conclusions:
MTI can detect white matter abnormalities in patients with MS and negative conventional brain MRI scans. The detection of such abnormalities may increase diagnostic confidence in those cases where MS is clinically suspected, but conventional MRI does not suggest the diagnosis.
Insights
Magnetization transfer imaging (MTI) detects subtle white matter changes in multiple sclerosis (MS) patients with normal conventional MRI scans. This advanced technique aids in diagnosing MS when standard imaging is inconclusive.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) often involves microscopic white matter damage not visible on conventional MRI.
- Magnetization transfer imaging (MTI) is a sensitive technique for detecting such subtle abnormalities.
Purpose of the Study:
- To evaluate the efficacy of MTI in identifying white matter changes in MS patients with clinically definite MS but negative conventional brain MRI.
- To determine if MTI can enhance diagnostic confidence in suspected MS cases.
Main Methods:
- Brain MRI and MTI were performed on 11 MS patients with negative conventional MRI scans.
- Patients were selected from a larger cohort of 618 definite MS cases across three Italian centers.
Main Results:
- Patients exhibited significantly lower mean MT ratios (MTR) in the pons, cerebellum, and periventricular regions compared to controls.
- Abnormal MTR values, indicative of white matter damage, were detected in the centra semiovalia in a significant percentage of patients.
Conclusions:
- MTI is effective in detecting white matter abnormalities in MS patients with normal conventional brain MRI.
- MTI can improve diagnostic confidence for MS when conventional MRI findings are negative.