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Updated: Aug 8, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple
Celia Oreja-Guevara1, Arnaud Charil, Domenico Caputo
1Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
Background:
Magnetization transfer (MT) magnetic resonance imaging (MRI) can provide in vivo quantitative estimates of microscopic tissue damage in normal-appearing white matter (NAWM) and gray matter (GM) from patients with multiple sclerosis (MS).
Objective:
To determine whether a one-time MT MRI can provide markers of short-term disease evolution in patients with relapsing-remitting MS.
Design:
Eighteen-month observational study.
Setting:
Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele.
Patients:
Twenty-two patients with untreated relapsing-remitting MS.
Main Outcome Measures:
Relapse rate; disability according to the Expanded Disability Status Scale (EDSS); dual-echo, 2-dimensional gradient echo with and without a saturation MT pulse and T1-weighted MRIs of the brain; and MT ratio (MTR) histograms for NAWM and GM.
Results:
During the study period, 13 patients (59%) experienced 25 relapses. The median EDSS score was 1.25 (range, 0-3.5) at study entry and 1.75 (range, 0-3) at study exit. Significant, although moderate, correlations were found between average GM MTR values at baseline and EDSS changes during the study period (r = -0.44; P = .04). A trend was observed for the correlation between NAWM MTR values at baseline and the EDSS changes throughout 18 months (r = -0.42; P = .05). For the relation between EDSS changes and baseline GM MTR, the slope of the regression line was -0.5 (95% confidence interval, -1.0 to 0.0), indicating that a decrease in the baseline GM MTR of 1% predicted an increase in the EDSS score of 0.5 point throughout the 18 months.
Conclusion:
This study indicates that a "snapshot" MT MRI assessment detects subtle brain tissue changes that are associated with short-term disability accumulation in patients with relapsing-remitting MS.
Insights
Magnetization transfer MRI detects subtle brain changes in multiple sclerosis (MS) patients. This imaging technique can predict short-term disability accumulation in relapsing-remitting MS.
Area of Science:
- Neuroimaging
- Medical Physics
- Neurology
Background:
- Magnetization transfer (MT) magnetic resonance imaging (MRI) quantifies microscopic tissue damage in multiple sclerosis (MS).
- MT MRI assesses normal-appearing white matter (NAWM) and gray matter (GM) in MS patients.
Purpose of the Study:
- To evaluate MT MRI as a marker for short-term disease progression in relapsing-remitting MS.
- To determine if a single MT MRI scan can predict future disability.
Main Methods:
- An 18-month observational study involving 22 untreated relapsing-remitting MS patients.
- Utilized dual-echo, 2D gradient echo MRI with and without MT pulse, and T1-weighted imaging.
- Analyzed MT ratio (MTR) histograms for NAWM and GM, relapse rates, and Expanded Disability Status Scale (EDSS) scores.
Main Results:
- 59% of patients experienced relapses during the study.
- Significant correlation found between baseline GM MTR and EDSS changes (r = -0.44, P = .04).
- A trend suggested baseline NAWM MTR correlates with EDSS changes (r = -0.42, P = .05).
Conclusions:
- A single MT MRI scan can identify subtle brain tissue changes in MS.
- These changes are linked to short-term disability progression in relapsing-remitting MS.
- MT MRI shows potential for monitoring disease evolution.
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