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Neurology 1999;52:845
© 1999 American Academy of Neurology
Articles

Magnetization transfer imaging of patients with definite MS and negative conventional MRI

M. Filippi, MD, M. A. Rocca, MD, L. Minicucci, PhD, V. Martinelli, MD, A. Ghezzi, MD, R. Bergamaschi, MD and G. Comi, MD

From the Neuroimaging Research Unit (Drs. Filippi, Rocca, and Minicucci) and Clinical Trials Unit (Drs. Martinelli and Comi), Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan; the Multiple Sclerosis Center (Dr. Ghezzi), Ospedale di Gallarate, University of Milan; and the Department of Neurology (Dr. Bergamaschi), Scientific Institute "C. Mondino," University of Pavia, Italy.

Address correspondence and reprint requests to Dr. Massimo Filippi, Neuroimaging Research Unit Department of Neuroscience, Scientific Institute Ospedale San Raffaele, Via Olgettina, 60, 20132 Milan, Italy.

OBJECTIVE: To assess, in a group of patients with clinically or laboratory-supported definite MS and negative conventional MRI scans of the brain, whether magnetization transfer imaging (MTI) is able to detect subtle white matter changes.

BACKGROUND: MTI of the brain in patients with MS frequently demonstrates the presence of microscopic damage to white matter, which appears normal on conventional MRI.

METHODS: Brain MRI and MTI scans were obtained from 11 patients with negative conventional MRIs of the brain, selected from 618 clinically or laboratory-supported definite MS cases scanned in the last 2 years in three Italian MS centers.

RESULTS: Compared with control subjects, patients had significantly lower mean MT ratios (MTR) in the pons, cerebellum, and periventricular regions. The percentages of pixels with MTR values below 1, 2, and 3 SD of the mean MTR value of the control subjects were 7.6% (range, 3.2% to 11.8%), 5.2% (range, 2.0% to 8.5%), and 3.6% (range, 1.2% to 6.1%), respectively. They were mainly located in the white matter of the centra semiovalia, and usually were isolated.

CONCLUSIONS: MTI can detect white matter abnormalities in patients with MS and negative conventional brain MRI scans. The detection of such abnormalities may increase diagnostic confidence in those cases where MS is clinically suspected, but conventional MRI does not suggest the diagnosis.




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