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Updated: Feb 20, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Long-Term Magnetization Transfer Ratio Evolution in Multiple Sclerosis White Matter Lesions
Yufan Zheng1,2, Jar-Chi Lee3, Richard Rudick4
1Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
Background And Purpose:
Magnetization transfer ratio (MTR), a magnetic resonance imaging technique used to assess tissue integrity, correlates with demyelination and axonal loss in multiple sclerosis (MS) lesions. In acute white matter lesions, short-term MTR changes mainly reflect demyelination and remyelination, in addition to edema and axonal and glial changes. Long-term MTR changes in MS lesions have not been studied extensively.
Methods:
A new quantitative image analysis method was developed to measure long-term MTR changes in MS lesions. The method was applied to a group of 59 patients and 14 healthy control subjects followed for 4 years. MTR changes in white matter lesions were analyzed, where lesion voxels were classified into six categories based on starting MTR and change over time. For each patient, the proportion of lesion voxels in each MTR-change category was calculated. Correlations between long-term MTR evolution, disability progression, and brain atrophy were investigated.
Results:
The proportion of lesion voxels in the high stable category correlated with less atrophy progression, while the proportion with low and increasing MTR correlated with increased atrophy. The proportion of lesion voxels in the high and stable MTR lesion category was significantly different between MS disease subgroups. The group with disability progression had a higher proportion of lesion voxels with low and increasing MTR.
Conclusions:
These results suggest that long-term changes in MTR in white matter lesions can be used to distinguish lesion subtypes associated with MS disease progression and improve understanding of the temporal evolution of MS pathology.
Insights
Long-term Magnetization Transfer Ratio (MTR) changes in multiple sclerosis (MS) lesions reveal distinct lesion subtypes. These MTR changes correlate with disease progression and brain atrophy, offering insights into MS pathology.
Area of Science:
- Neuroimaging
- Magnetic Resonance Imaging (MRI)
- Pathology
Background:
- Magnetization transfer ratio (MTR) assesses tissue integrity and correlates with demyelination/axonal loss in multiple sclerosis (MS).
- Short-term MTR changes in acute MS lesions reflect demyelination, remyelination, edema, and axonal/glial changes.
- Long-term MTR changes in MS lesions remain understudied.
Purpose of the Study:
- To develop and apply a quantitative image analysis method for measuring long-term MTR changes in MS lesions.
- To investigate correlations between long-term MTR evolution, disability progression, and brain atrophy in MS patients.
Main Methods:
- A quantitative image analysis method was developed to measure long-term MTR changes.
- 59 MS patients and 14 healthy controls were followed for 4 years.
- Lesion voxels were classified into six categories based on MTR and temporal change; proportions were calculated per patient.
Main Results:
- The proportion of high, stable MTR lesion voxels correlated with less atrophy progression.
- A higher proportion of low, increasing MTR lesion voxels correlated with increased atrophy.
- MS disease subgroups showed significant differences in high, stable MTR lesion voxel proportions; progressive MS had more low, increasing MTR lesions.
Conclusions:
- Long-term MTR changes in MS white matter lesions can distinguish subtypes associated with disease progression.
- This approach enhances understanding of the temporal evolution of MS pathology.
- MTR analysis offers a potential tool for characterizing MS lesion subtypes and progression.
