White Matter Evaluation in Multiple Sclerosis Through Magnetic Resonance Kurtosis Imaging

Area of Science:

• Neuroimaging
• Radiology
• Biomedical Engineering

Background:

• Multiple Sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
• Conventional MRI is crucial for diagnosing and monitoring MS, but advanced diffusion techniques can offer more detailed insights.
• Understanding microstructural changes in MS lesions and white matter (WM) is vital for assessing disease progression and treatment efficacy.

Purpose of the Study:

• To investigate diffusional changes in multiple sclerosis (MS) plaques and non-Gaussian water diffusion behavior.
• To evaluate the utility of Diffusional Kurtosis Imaging (DKI) in characterizing MS-related tissue alterations.
• To compare DKI parameters between MS patients and healthy controls.

Main Methods:

• 31 MS patients and 21 healthy controls underwent MRI at 3T.
• Diffusional Kurtosis Imaging (DKI) was employed to acquire diffusion data.
• Mean Kurtosis (MK) parametric maps were computed, with regions of interest (ROIs) defined in white matter (WM) for controls and in MS plaques and WM for patients.

Main Results:

• No significant differences in WM kurtosis or skewness were observed between MS patients and controls (p=0.213 and p=0.390, respectively).
• In MS patients, kurtosis and skewness values were significantly higher in plaques (Plaque 1, 2, 3) and WM compared to controls (p<0.0001).
• DKI revealed significantly elevated intensity values (maximum, minimum, median) in MS plaques and WM.

Conclusions:

• Diffusional Kurtosis Imaging (DKI) provides a more comprehensive characterization of lesions and white matter in MS.
• DKI may serve as a sensitive indicator of tissue damage and microstructural changes in MS.
• DKI complements conventional diffusion evaluations for assessing MS pathology.