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Related Experiment Video

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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Diffusion basis spectrum imaging and diffusion tensor imaging predict persistent black hole formation in multiple

Lindsey Wooliscroft1, Amber Salter2, Gautam Adusumilli3

  • 1Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Neurology, VA Portland Health Care System, Portland, OR, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.

Multiple Sclerosis and Related Disorders
|February 15, 2024
PubMed
Summary
This summary is machine-generated.

Diffusion basis spectrum imaging (DBSI) and diffusion tensor imaging (DTI) can predict persistent black holes (PBHs) in multiple sclerosis (MS). Higher DBSI non-restricted fraction and lower DBSI restricted fraction in acute lesions indicate future tissue destruction.

Keywords:
Diffusion basis spectrum imagingDiffusion tensor imagingEnhancing lesionsMultiple sclerosisPersistent black holes

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Area of Science:

  • Neuroimaging
  • Radiology
  • Multiple Sclerosis Research

Background:

  • Diffusion basis spectrum imaging (DBSI) offers higher histopathologic specificity than diffusion tensor imaging (DTI) by analyzing multiple diffusion tensors.
  • Persistent black holes (PBHs) in multiple sclerosis (MS) signify severe tissue damage and correlate with increased disability.
  • Predicting PBH development from acute contrast-enhancing lesions (CELs) is crucial for understanding MS progression.

Purpose of the Study:

  • To assess the predictive capability of DBSI and DTI metrics for the evolution of acute CELs into PBHs over 12 months.
  • To investigate the relationship between specific diffusion parameters (DBSI and DTI) in acute CELs and subsequent PBH formation.

Main Methods:

  • A prospective cohort study involving relapsing MS patients with at least one CEL.
  • Monthly MRI scans for 4-6 months to track CELs until gadolinium resolution.
  • Quantification of DBSI and DTI metrics at the time of maximal CEL conspicuity, with follow-up MRI at least 12 months later to identify PBHs.

Main Results:

  • Of 164 CELs in 20 MS participants, 59 (36%) evolved into PBHs.
  • DTI radial diffusivity (RD) and axial diffusivity (AD) were significantly elevated in CELs that became PBHs.
  • DBSI non-restricted fraction (indicating edema/extracellular space) above 0.45 and DBSI restricted fraction below 0.07 were significant predictors of PBH development.

Conclusions:

  • Increased edema and extracellular space within acute CELs, as indicated by DBSI metrics, predict subsequent tissue destruction and PBH formation.
  • DBSI metrics, particularly the non-restricted and restricted fractions, show promise in predicting PBH development in MS.