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Updated: May 21, 2026
Manual Segmentation of the Human Choroid Plexus Using Brain MRI
Published on: December 15, 2023
Longitudinal changes of choroid plexus volumes and MRI ratios in multiple sclerosis
Britta Krieger1, Barbara Bellenberg1, Dajana Müller1
1Ruhr University Bochum, St. Josef Hospital, Institute of Neuroradiology, 44791 Bochum, Germany.
Abstract:
This longitudinal study aimed to identify the predictive role of choroid plexus enlargement for disability progression and its association with tissue damage in early multiple sclerosis patients. Forty patients with clinically isolated syndrome or early relapsing-remitting multiple sclerosis underwent brain MRI scanning at baseline, after 2 and after 6-8 years. FreeSurfer segmentation was used for brain volume estimation, and the choroid plexus was segmented by use of an independent automated segmentation tool. MRI ratios (T1 weighted through fluid attenuated inversion recovery image values) were calculated after calibration and subtracting lesion masks. Lesion masks were eroded to obtain both lesion rims and centres, for which mean ratios were extracted in addition to normal-appearing white matter. Expanded Disability Status Scale and disease duration were collected from neurological examination. Between baseline and last follow-up, choroid plexus volumes increased, and MRI ratios in lesions decreased significantly, which was dominated by the decrease in clinically isolated syndrome rather than relapsing-remitting patients and more pronounced in lesion rims than in their centre. Choroid plexus volumes were significantly related to MRI ratios within rims of lesions at baseline and within lesion centres after 6-8 years, but not within normal-appearing white matter. No associations between choroid plexus volumes or ratios and disability were found. We observed longitudinal changes of both choroid plexus enlargement and MRI ratios over 6-8 years in early multiple sclerosis patients. Choroid plexus enlargement seemed involved in the dynamic development of lesion destructivity.
Insights
Choroid plexus enlargement in early multiple sclerosis patients correlates with lesion damage over time but does not predict disability progression. This finding offers insights into the disease
Area of Science:
- Neuroimmunology
- Neuroimaging
- Multiple Sclerosis Research
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Early MS involves tissue damage and potential disability progression, with choroid plexus changes being a potential factor.
- Understanding the role of the choroid plexus in MS pathogenesis is crucial for early intervention.
Purpose of the Study:
- To investigate the predictive value of choroid plexus enlargement for disability progression in early MS.
- To examine the association between choroid plexus volume changes and tissue damage markers over 6-8 years.
- To explore the relationship between MRI-derived lesion characteristics and choroid plexus volume longitudinally.
Main Methods:
- Longitudinal brain MRI analysis in 40 early MS patients (clinically isolated syndrome or relapsing-remitting MS).
- Automated segmentation of choroid plexus volume and brain structures using FreeSurfer.
- Calculation of MRI ratios within lesions (rims and centers) and normal-appearing white matter; clinical data collection (EDSS, disease duration).
Main Results:
- Significant increases in choroid plexus volumes and decreases in lesion MRI ratios were observed over 6-8 years.
- Lesion ratio changes were more pronounced in clinically isolated syndrome and in lesion rims.
- Choroid plexus volumes correlated with lesion MRI ratios at baseline and follow-up, but not with normal-appearing white matter or disability progression.
Conclusions:
- Choroid plexus enlargement is associated with the dynamic development of lesion destructivity in early MS.
- Longitudinal changes in choroid plexus volume and lesion characteristics occur over time in early MS.
- Choroid plexus enlargement does not appear to predict disability progression in this cohort.
