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Diffusion tensor imaging of occult injury of optic radiation following optic neuritis in multiple sclerosis
Jiafeng Chen1, Lijun Zhu2, He Li1
1Department of Neurology, Neuroscience Centre, The First Teaching Hospital of Jilin University, Changchun, Jilin 130012, P.R. China.
Abstract:
Multiple sclerosis (MS) is easily detected by routine magnetic resonance imaging (MRI). However, it is not possible to detect early or occult lesions in MS by routine MRI, and this may explain the inconsistency between the severity of the lesions found by MRI and the degree of clinical disability of patients with MS. The present study included 10 patients with relapsing-remitting MS and 10 healthy volunteers. Each patient underwent routine 3.0 T MRI, diffusion tensor imaging (DTI), and diffusion tensor tractography (DTT). Optic nerve and optic radiation were analyzed by DTI and DTT. The fractional anisotropy (FA), mean diffusivity (MD), λ//, and λ┴ values were measured. In the 10 patients with MS, 7 optic nerves were affected, and 13 optic nerves were not affected. Cranial MRI showed that optic nerve thickening and hyperintensity occurred in 2 patients with MS. In the directionally encoded color maps, a hypointensive green signal in the optic nerve was observed in 3 patients with MS. The FA values were significantly lower and the MD, λ//, and λ┴ values were significantly higher in the affected and unaffected optic nerves and optic radiations in patients with MS in comparison with controls (P<0.05). There were no significant differences in these values between the affected and unaffected optic nerves and optic radiation in patients with MS (P>0.05). Diffusion tensor imaging is sensitive in the detection of occult injury of the optic nerve and optic radiation following optic neuritis. Diffusion tensor imaging may be a useful tool for the early diagnosis, treatment and management of MS.
Insights
Diffusion tensor imaging (DTI) detects subtle optic nerve and radiation damage in multiple sclerosis (MS) not visible with standard MRI. DTI shows early injury, aiding MS diagnosis and management.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) diagnosis relies on MRI, but routine scans miss early or occult lesions.
- This discrepancy between MRI findings and clinical disability in MS patients is common.
- Standard MRI may not fully capture the extent of optic nerve and radiation involvement.
Purpose of the Study:
- To evaluate the sensitivity of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in detecting early optic nerve and radiation damage in MS.
- To compare DTI/DTT metrics between MS patients and healthy controls.
- To explore the utility of DTI in assessing occult injuries in MS.
Main Methods:
- 10 relapsing-remitting MS patients and 10 controls underwent routine 3.0 T MRI, DTI, and DTT.
- Optic nerves and optic radiations were analyzed using DTI and DTT.
- Fractional anisotropy (FA) and mean diffusivity (MD), including λ// and λ┴, were measured.
Main Results:
- DTI/DTT revealed abnormalities in both affected and unaffected optic nerves/radiations in MS patients.
- Significantly lower FA and higher MD, λ//, and λ┴ values were observed in MS patients compared to controls (P<0.05).
- No significant differences were found between affected and unaffected nerves/radiations within MS patients.
Conclusions:
- Diffusion tensor imaging (DTI) is sensitive for detecting occult optic nerve and radiation injury in MS.
- DTI may serve as a valuable tool for early diagnosis and management of MS.
- DTI offers insights into the subclinical neurodegenerative processes in MS.
