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Analysis of normal-appearing white matter in multiple sclerosis: comparison of diffusion tensor MR imaging and
A C Guo1, V L Jewells, J M Provenzale
1Department of Radiology, Duke University Medical Center, Durham 27710, NC, USA.
Background And Purpose:
Our purpose was to compare diffusion tensor MR and magnetization transfer imaging in assessing normal-appearing white matter (WM) regions in multiple sclerosis (MS).
Methods:
Diffusion tensor, magnetization transfer, and conventional MR imaging were performed in 12 patients with MS. Fractional anisotropy, apparent diffusion coefficients (ADCs), and magnetization transfer ratios (MTRs) were measured in plaques, normal-appearing periplaque WM (PWM) regions, and normal-appearing WM regions remote from plaques. Mean fractional anisotropy, ADCs, and MTRs were calculated and compared in WM regions.
Results:
Fractional anisotropy was lower in normal-appearing PWM regions than in remote WM regions (P <.001) but higher than in plaques (P <.001). MTRs were lower (not significantly, P =.19) in normal-appearing PWM regions than in remote regions. MTRs were higher in normal-appearing PWM regions than in plaques (P <.001). ADCs were higher in normal-appearing PWM regions than in remote regions (P =.008) but lower than in plaques (P =.001). Correlation between fractional anisotropy and MTRs of individual lesions was poor (r = 0.18) and between fractional anisotropy and ADC, modest (r = -0.39).
Conclusion:
In MS, diffusion tensor MR imaging can depict differences between WM regions that are not apparent on conventional MR images. Anisotropy measurements may be more sensitive than those of MTRs in detecting subtle abnormalities in PWM.
Insights
Diffusion tensor MRI reveals subtle white matter changes in multiple sclerosis (MS) patients. Anisotropy measurements are more sensitive than magnetization transfer ratios in detecting these abnormalities in normal-appearing white matter.
Area of Science:
- Neuroimaging
- Radiology
- Medical Physics
Background:
- Multiple sclerosis (MS) involves white matter (WM) damage.
- Assessing normal-appearing WM in MS is crucial for understanding disease progression.
- Conventional MRI may not detect subtle WM abnormalities.
Purpose of the Study:
- To compare diffusion tensor MRI (DT-MRI) and magnetization transfer imaging (MTI) for assessing normal-appearing WM in MS.
- To evaluate the sensitivity of DT-MRI metrics (fractional anisotropy, apparent diffusion coefficients) and MTI metrics (magnetization transfer ratios) in MS.
Main Methods:
- DT-MRI, MTI, and conventional MRI were performed on 12 MS patients.
- Measurements included fractional anisotropy, apparent diffusion coefficients (ADCs), and magnetization transfer ratios (MTRs).
- These metrics were analyzed in plaques, periplaque WM (PWM), and remote WM regions.
Main Results:
- Fractional anisotropy was significantly lower in PWM than remote WM, and higher than in plaques.
- MTRs showed no significant difference between PWM and remote WM but were higher in PWM than plaques.
- ADCs were higher in PWM than remote WM, and lower than in plaques.
Conclusions:
- DT-MRI can detect WM differences not visible with conventional MRI in MS.
- Anisotropy measurements appear more sensitive than MTRs for detecting subtle abnormalities in periplaque WM in MS.