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Neurology 2000;54:1139-1144
© 2000 American Academy of Neurology
Articles

Pathologic damage in MS assessed by diffusion-weighted and magnetization transfer MRI

M. Cercignani, MPhil, G. Iannucci, MD, M. A. Rocca, MD, G. Comi, MD, M. A. Horsfield, PhD and M. Filippi, MD

From the Neuroimaging Research Unit (Drs. Cercignani, Iannucci, Rocca, and Filippi) and the Clinical Trials Unit (Dr. Comi), Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy; and the Division of Medical Physics (Dr. Horsfield), University of Leicester, Leicester Royal Infirmary, UK.

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 compare diffusion characteristics of MS lesions, normal-appearing white matter (NAWM) from patients, and normal white matter from control subjects, and to investigate the correlations between the magnetization transfer ratio (MTR) and a directionally averaged tissue water diffusion coefficient () in patients.

BACKGROUND: MS and other pathologic processes that modify tissue integrity can result in abnormal diffusion of water molecules detectable by diffusion-weighted imaging (DWI).

METHODS: Conventional dual-echo and DWI scans were obtained from 35 patients with relapsing-remitting MS and 24 healthy control subjects. MT scans were also obtained from the patients. After coregistration of all scans, MTR and values from MS lesions and NAWM in different regions were marked using the dual-echo scans as a reference. values from the same brain regions in control subjects were acquired. Histograms of MTR and were also produced.

RESULTS: Patients with MS had significantly higher values in all the areas studied. Moreover, histogram metrics (peak height, peak site, and average ) from patients were substantially different from those of control subjects. In patients, average lesion and MTR were markedly different from those in the NAWM. There was an inverse correlation between average lesion MTR and inside lesions, whereas no correlation was found for average MTR and taken from the histograms.

CONCLUSIONS: DWI detects severe tissue disruption inside lesions and subtle widespread abnormalities in NAWM in patients with relapsing-remitting MS. MT and DWI may provide information about different aspects of brain pathology in MS.

Key words: Multiple sclerosis—Diffusion-weighted imaging—Magnetization transfer imaging.




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