Reduced perfusion in white matter lesions in multiple sclerosis
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Updated: Apr 3, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Piotr Sowa1, Atle Bjørnerud2, Gro O Nygaard3
1Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Objective:
To investigate dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) in white matter lesions (WML) in patients with multiple sclerosis (MS), using automatically generated binary masks of brain tissue.
Background:
WML in MS have in some studies demonstrated perfusion abnormalities compared to normal appearing white matter (NAWM), however perfusion changes in WML in MS have in general not been well documented.
Methods:
DSC PWI was performed at 1.5 Tesla in 69 newly diagnosed MS patients. Parametric perfusion maps representing cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) were obtained. Binary masks of WML, white matter (WM) and grey matter (GM) were automatically generated and co-registered to the perfusion maps. The WML mask was manually edited and modified to correct for errors in the automatic lesion detection. Perfusion parameters were derived both from WML and NAWM using the manually modified WML mask, and using the original non-modified WML mask (with and without GM exclusion mask). Differences in perfusion measures between WML and NAWM were analyzed.
Results:
CBF was significantly lower (p<0.001) and MTT significantly higher (p<0.001) in WML compared to NAWM. CBV did not show significant difference between WML and NAWM. The non-modified WML mask gave similar results as manually modified WML mask if the GM exclusion mask was used in the analysis.
Conclusions:
DSC PWI revealed lower CBF and higher MTT, consistent with reduced perfusion, in WML compared to NAWM in patients with early MS. Automatically generated binary masks are a promising tool in perfusion analysis of WML.
Insights
Dynamic susceptibility contrast perfusion imaging in multiple sclerosis (MS) white matter lesions (WML) shows reduced cerebral blood flow and prolonged transit time. Automated lesion masking aids perfusion analysis in early MS.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- White matter lesions (WML) in multiple sclerosis (MS) may exhibit perfusion abnormalities.
- Perfusion changes within MS WML remain incompletely documented.
Purpose of the Study:
- To investigate dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) in WML of MS patients.
- To evaluate perfusion parameters in WML compared to normal-appearing white matter (NAWM).
Main Methods:
- DSC PWI performed on 69 newly diagnosed MS patients at 1.5 Tesla.
- Generated parametric maps for cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT).
- Utilized automatically generated and manually edited binary masks for WML, white matter (WM), and grey matter (GM) segmentation.
Main Results:
- Significantly lower CBF (p<0.001) and higher MTT (p<0.001) observed in WML compared to NAWM.
- No significant difference in CBV between WML and NAWM.
- Automated masking with GM exclusion yielded results comparable to manual editing.
Conclusions:
- DSC PWI indicates reduced perfusion (lower CBF, higher MTT) in early MS WML compared to NAWM.
- Automated binary masks show potential as a valuable tool for WML perfusion analysis.
