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Fiber density index in the evaluation of the spinal cord in patients with multiple sclerosis
M Ukmar1, A Montalbano, E Makuc
1U.C.O. di Radiologia, Ospedale di Cattinara, Azienda Ospedaliero-Universitaria, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy. majaukmar@alice.it
Purpose:
The aims of this study were to determine fractional anisotropy (FA) and the fibre density index (FDi) in the cervical spinal cord of patients with multiple sclerosis (MS) by using diffusion-tensor magnetic resonance imaging (DT-MRI) to identify possible differences between MS patients and controls.
Materials And Methods:
We studied 27 patients with MS - nine with primary progressive (PPMS), nine with secondary progressive (SPMS) and nine with relapsing-remitting (RRMS) disease - and 18 healthy individuals as controls. Conventional and DTI sequences with diffusion gradients applied in 32 directions were obtained. The results were compared between healthy controls and patients, between healthy controls and individual forms of MS and between the three forms of MS. Statistical analysis was performed by analysis of variance (ANOVA) and Student's t test.
Results:
The FDi in the three subgroups of patients and in controls showed a statistically significant difference. Using the t test, we found results from both PPMS and SPMS groups were different from controls. The correlation between FA and FDi was significant both in healthy controls and in MS patients evaluated as a single group. CONSLUCIONS: Despite the small group of patients, these findings suggest that FDi associated with FA is a sensitive parameter for assessing spinal cord damage in patients with MS.
Insights
Diffusion-tensor magnetic resonance imaging (DT-MRI) revealed significant differences in the fibre density index (FDi) in the cervical spinal cord of multiple sclerosis (MS) patients compared to controls.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Cervical spinal cord damage is a significant contributor to disability in MS patients.
- Diffusion-tensor magnetic resonance imaging (DT-MRI) offers advanced insights into white matter microstructure.
Purpose of the Study:
- To quantify fractional anisotropy (FA) and fibre density index (FDi) in the cervical spinal cord of MS patients using DT-MRI.
- To compare these diffusion metrics between MS patients and healthy controls.
- To identify potential differences across various MS subtypes (PPMS, SPMS, RRMS).
Main Methods:
- A cohort of 27 MS patients (9 PPMS, 9 SPMS, 9 RRMS) and 18 healthy controls were recruited.
- Conventional and DT-MRI sequences with 32 diffusion directions were acquired.
- Statistical analysis included ANOVA and Student's t-test to compare groups.
Main Results:
- A statistically significant difference in FDi was observed across all patient subgroups and controls.
- Both primary progressive MS (PPMS) and secondary progressive MS (SPMS) groups showed significant differences compared to controls.
- A significant correlation was found between FA and FDi in both healthy controls and the overall MS patient group.
Conclusions:
- Fibre density index (FDi), in conjunction with fractional anisotropy (FA), appears to be a sensitive imaging biomarker for detecting spinal cord damage in MS.
- These findings highlight the potential of advanced DT-MRI metrics for assessing disease-related microstructural changes in the cervical spinal cord.
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