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Updated: Sep 23, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Diffusion magnetic resonance imaging of normal-appearing white matter in multiple sclerosis: correlation with brain
Hana Larassati1, Jacub Pandelaki1, Riwanti Estiasari2
1Radiology Department, Dr. Cipto Mangunkusumo General Hospital and Universitas Indonesia, Jakarta, Indonesia.
Background:
Diffusion magnetic resonance imaging (MRI) abnormalities in multiple sclerosis (MS) are not limited to lesions, but have also been observed in the white matter that appears normal on conventional MRI sequences, known as normal-appearing white matter (NAWM). There is evidence of microstructural processes occurring in the NAWM.
Objective:
To assess the correlation between NAWM apparent diffusion coefficient (ADC) and fractional anisotropy (FA) with brain volume and clinical disability in MS.
Methods:
Brain MRI from 33 MS patients were included. ADC and FA measurements of the genu, body, and splenium of corpus callosum (CC) were done. ADC and FA values were analyzed to measure their correlation with brain volume from MR volumetry and clinical disability represented by Expanded Disability Status Scale (EDSS).
Results:
The mean ADC of CC NAWM was .93 ×10-3 mm2/s (±.13 SD), and the mean FA .72 (±.12 SD). ADC and FA of CC NAWM were significantly correlated with the ratio of brain volume to intracranial volume (R = -0,70 and 0,78 respectively), and with EDSS (R = .52 and -.59 respectively).
Conclusion:
There were significant correlations between ADC and FA of NAWM with brain volume and EDSS of MS patients. Further longitudinal studies were needed to evaluate the potential of diffusion MRI in the evaluation of MS.
Insights
Diffusion MRI measures in normal-appearing white matter (NAWM) correlate with brain volume and disability in multiple sclerosis (MS). These findings highlight diffusion MRI
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Diffusion MRI reveals abnormalities in normal-appearing white matter (NAWM) in multiple sclerosis (MS), indicating subclinical microstructural changes.
- These changes in NAWM suggest ongoing pathological processes beyond visible lesions in MS patients.
Purpose of the Study:
- To investigate the relationship between diffusion MRI metrics (ADC and FA) in MS NAWM and key indicators of disease severity.
- To assess correlations between NAWM diffusion parameters, overall brain volume, and clinical disability (EDSS) in multiple sclerosis.
Main Methods:
- Analyzed diffusion MRI data (ADC and FA) from the corpus callosum NAWM in 33 MS patients.
- Correlated diffusion metrics with brain volume (using MR volumetry) and Expanded Disability Status Scale (EDSS) scores.
Main Results:
- Significant correlations were found between NAWM ADC and FA values and the brain volume to intracranial volume ratio (R = -0.70 and 0.78, respectively).
- NAWM diffusion metrics also showed significant correlations with clinical disability as measured by EDSS (R = 0.52 and -0.59, respectively).
Conclusions:
- Diffusion MRI metrics in NAWM are significantly associated with both brain atrophy and clinical disability in MS patients.
- These findings suggest diffusion MRI's potential utility in monitoring MS progression and evaluating treatment efficacy, warranting further longitudinal studies.
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