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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Evaluation of the Sensitivity of Inhomogeneous Magnetization Transfer (ihMT) MRI for Multiple Sclerosis
E Van Obberghen1, S Mchinda1, A le Troter1
1From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France.
Background And Purpose:
Inhomogeneous magnetization transfer is a new endogenous MR imaging contrast mechanism that has demonstrated high specificity for myelin. Here, we tested the hypothesis that inhomogeneous magnetization transfer is sensitive to pathology in a population of patients with relapsing-remitting MS in a way that both differs from and complements conventional magnetization transfer.
Materials And Methods:
Twenty-five patients with relapsing-remitting MS and 20 healthy volunteers were enrolled in a prospective MR imaging research study, whose protocol included anatomic imaging, standard magnetization transfer, and inhomogeneous magnetization transfer imaging. Magnetization transfer and inhomogeneous magnetization transfer ratios measured in normal-appearing brain tissue and in MS lesions of patients were compared with values measured in control subjects. The potential association of inhomogeneous magnetization transfer ratio variations with the clinical scores (Expanded Disability Status Scale) of patients was further evaluated.
Results:
The magnetization transfer ratio and inhomogeneous magnetization transfer ratio measured in the thalami and frontal, occipital, and temporal WM of patients with MS were lower compared with those of controls (P < .05). The mean inhomogeneous magnetization transfer ratio measured in lesions was lower than that in normal-appearing WM (P < .05). Significant (P < .05) negative correlations were found between the clinical scores and inhomogeneous magnetization transfer ratio measured in normal-appearing WM structures. Weaker nonsignificant correlation trends were found for the magnetization transfer ratio.
Conclusions:
The sensitivity of the inhomogeneous magnetization transfer technique for MS was highlighted by the reduction in the inhomogeneous magnetization transfer ratio in MS lesions and in normal-appearing WM of patients compared with controls. Stronger correlations with the Expanded Disability Status Scale score were obtained with the inhomogeneous magnetization transfer ratio compared with the standard magnetization transfer ratio, which may be explained by the higher specificity of inhomogeneous magnetization transfer for myelin.
Insights
Inhomogeneous magnetization transfer (IMT) shows promise for detecting multiple sclerosis (MS) pathology. IMT ratios in MS lesions and normal-appearing white matter were reduced and correlated better with disability than standard magnetization transfer.
Area of Science:
- Neuroimaging
- Biomedical Engineering
- Radiology
Background:
- Inhomogeneous magnetization transfer (IMT) is an emerging endogenous MRI contrast mechanism with high specificity for myelin.
- Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system.
Purpose of the Study:
- To test if IMT is sensitive to MS pathology.
- To compare IMT with conventional magnetization transfer (MT) in MS patients.
Main Methods:
- Prospective MRI study of 25 relapsing-remitting MS patients and 20 healthy controls.
- Acquisition of anatomic imaging, standard MT, and IMT imaging.
- Comparison of MT and IMT ratios in normal-appearing white matter (NAWM) and MS lesions between patients and controls.
Main Results:
- MT and IMT ratios were significantly lower in MS patients' thalami and white matter compared to controls.
- IMT ratios were significantly lower in MS lesions and NAWM compared to controls.
- IMT ratios in NAWM showed significant negative correlations with Expanded Disability Status Scale (EDSS) scores, unlike standard MT.
Conclusions:
- IMT is sensitive to MS pathology, detecting reductions in lesions and NAWM.
- IMT demonstrates higher specificity for myelin, correlating better with clinical disability than standard MT.
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