Related Experiment Video
Updated: Oct 27, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Perivascular Diffusivity and Periventricular Susceptibility Changes in Relapsing-Remitting Multiple Sclerosis: A
R B Revanth1, K A Smitha1, S S Jithin1
1Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India.
Background:
Progressive periventricular damage in multiple sclerosis (MS) has been linked to impaired perivascular clearance and to susceptibility changes attributed to iron deposition and myelin loss. Their relationship is unclear.
Purpose/Hypothesis:
To compare diffusion tensor image analysis along the perivascular space (DTI-ALPS) and periventricular quantitative susceptibility mapping (QSM) between relapsing-remitting multiple sclerosis (RRMS) patients and healthy controls; and to evaluate their correlation and relationships with clinical disability (Expanded Disability Status Scale, EDSS).
Study Type:
Retrospective case-control study.
Population/Subjects:
Thirty one patients with RRMS (mean age, 34.6 ± 8.4 years) and 30 age- and sex-matched healthy controls (mean age, 34.2 ± 8.1 years).
Field Strength/Sequence:
1.5 T; Diffusion tensor imaging (DTI) and multi-echo gradient-echo (GRE) sequences.
Assessment:
DTI-ALPS index and periventricular QSM values were measured from manually placed bilateral regions of interest (ROIs). Standardized Montreal Neurological Institute (MNI)-space coordinates were used for DTI-ALPS analysis, and QSM ROIs in periventricular normal-appearing white matter were reviewed by a neuroradiologist. Disability was assessed using the EDSS.
Statistical Tests:
Groups were compared using independent-samples t-tests and Cohen's d. Correlations were assessed using Pearson's r, with Spearman's rho as a sensitivity analysis (p < 0.05, two-tailed).
Results:
DTI-ALPS was lower in MS patients than controls (1.27 ± 0.22 vs. 1.45 ± 0.22; d = 0.828), whereas periventricular QSM was higher (-15.35 ± 4.92 vs. -21.70 ± 6.40 ppb; d = 1.116). A strong negative correlation between the two biomarkers was observed across all subjects (r = -0.738). Both measures correlated with EDSS (DTI-ALPS r = -0.509; QSM r = 0.501) and differed between EDSS subgroups (EDSS > 2.0 vs. ≤ 2.0: DTI-ALPS 1.160 vs. 1.364; QSM -12.33 vs. -17.83 ppb).
Data Conclusion:
Reduced DTI-ALPS and higher periventricular QSM-derived susceptibility were each moderately associated with disability in RRMS. The negative DTI-ALPS-QSM correlation in both groups indicates an association between perivascular diffusivity, a putative marker of glymphatic function, and periventricular QSM-derived susceptibility; causality cannot be established from this cross-sectional design.
Stage Of Technical Efficacy:
2.
