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Updated: Oct 1, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Microstructural white matter abnormalities in multiple sclerosis and neuromyelitis optica spectrum disorders:
Shimpei Kato1, Akifumi Hagiwara2, Kazumasa Yokoyama3
1Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Introduction:
Despite differences in the pathogenesis and treatment of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), it remains difficult to distinguish them. In this study, we aimed to discriminate between MS and NMOSD using diffusion tensor imaging (DTI), free water (FW) imaging, and neurite orientation dispersion and density imaging (NODDI).
Methods:
Thirty patients with relapsing-remitting (RR) MS, 18 NMOSD patients with positive anti-aquaporin-4 immunoglobulin G seroreactivity, and 20 age- and sex- matched currently healthy subjects underwent MRI. The differences in the DTI (fractional anisotropy [FA], axial diffusivity [AD], mean diffusivity [MD], and radial diffusivity [RD]), FW and FW-corrected DTI, and NODDI indices between the three groups were evaluated using tract-based spatial statistics (TBSS) and region-of-interest (ROI) analyses.
Results:
The ROI analysis of lesions indicated that the RRMS group had significantly higher AD, MD, RD, ISO and FW-corrected AD, and MD; and lower intracellular volume fraction (ICVF) than the NMOSD group. TBSS analysis showed increased water content in RRMS patients compared to NMOSD patients. Compared with healthy controls (HCs) using TBSS and ROI analysis, the changes in FW imaging indices were more limited than those of in DTI in RRMS patients.
Conclusion:
FW imaging and NODDI were useful for identifying the etiology of neurodegeneration- and neuroinflammation-related microstructural changes in RRMS and NMOSD patients.
Insights
Diffusion tensor imaging (DTI), free water (FW) imaging, and neurite orientation dispersion and density imaging (NODDI) can differentiate between multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). These advanced MRI techniques reveal distinct microstructural changes in MS and NMOSD patients.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Distinguishing multiple sclerosis (MS) from neuromyelitis optica spectrum disorders (NMOSD) is clinically challenging due to overlapping symptoms and pathogenesis.
- Advanced neuroimaging techniques are crucial for accurate differential diagnosis.
Purpose of the Study:
- To discriminate between MS and NMOSD using diffusion tensor imaging (DTI), free water (FW) imaging, and neurite orientation dispersion and density imaging (NODDI).
- To identify unique microstructural changes associated with each condition.
Main Methods:
- MRI scans were performed on 30 relapsing-remitting MS patients, 18 NMOSD patients (anti-aquaporin-4 IgG positive), and 20 healthy controls.
- Tract-based spatial statistics (TBSS) and region-of-interest (ROI) analyses were used to evaluate DTI, FW, and NODDI indices.
Main Results:
- Region-of-interest (ROI) analysis revealed higher axial diffusivity (AD), mean diffusivity (MD), radial diffusivity (RD), and free water (FW) content in MS patients compared to NMOSD patients.
- TBSS analysis indicated increased water content in MS patients versus NMOSD patients.
- FW imaging showed more limited changes in MS patients compared to DTI findings.
Conclusions:
- Free water (FW) imaging and NODDI are valuable tools for identifying neurodegeneration and neuroinflammation-related microstructural changes in MS and NMOSD.
- These advanced MRI techniques aid in differentiating between MS and NMOSD.
