A diffusion tensor imaging group study of the spinal cord in multiple sclerosis patients with and without T₂ spinal cord lesions

Abstract

Purpose: To examine the T 2 -normal appearing spinal cord of patients with multiple sclerosis (MS) using diffusion tensor imaging. Materials and Methods:Diffusion tensor images of the spinal cord were acquired from 21 healthy subjects, 11 MS patients with spinal cord lesions, and 10 MS patients without spinal cord lesions on the T 2 -weighted MR images. Different diffusion measures were evaluated using both a region of interest (ROI) -based and a diffusion tensor tractography-based segmentation approach.Results: It was observed that the FA, the transverse diffusivity Ќ , and the ratio of the longitudinal and transverse diffusivities ( / Ќ ) were significantly lower in the spinal cord of MS patients with spinal cord lesions compared with the control subjects using both the ROI method (P ϭ 0.014, P ϭ 0.028, and P ϭ 0.039, respectively) and the tractography-based approach (P ϭ 0.006, P ϭ 0.037, and P ϭ 0.012, respectively). For both image analysis methods, the FA and the / Ќ values were significantly different between the control group and the MS patient group without T 2 spinal cord lesions (P ϭ 0.013). Conclusion:Our results suggest that the spinal cord may still be affected by MS, even when lesions are not detected on a conventional MR scan. In addition, we demonstrated that diffusion tensor tractography is a robust tool to analyze the spinal cord of MS patients.

Reduced Field-of-View Diffusion Imaging of the Human Spinal Cord: Comparison with Conventional Single-Shot Echo-Planar Imaging

“…[1][2][3][4][5] Interest in spinal cord DWI is increasing, however, because it is expected to be useful in a diverse range of pathology, including demyelinating disease, [6][7][8][9] infarction, 10-15 myelopathy, [16][17][18][19] and traumatic injury. [20][21][22][23] Furthermore, diffusion images serve as the raw data for DTI, 9,19,[23][24][25][26][27][28][29] which enables the mapping of white matter tracts; this could improve clinical management of pathologies such as neoplasms and spinal cord injury.…”

Functional MRI of the Spinal Cord: Diffusion-Weighted, Diffusion Tensor Imaging, and Fiber Tractography

“…Not surprisingly, a number of authors have found DTI changes in the NASC in patients with MS ( Fig. 45.2) [7,17]. A review of the literature demonstrates fairly good concordance when comparing the FA in the spinal cord in MS patients compared with controls.…”

Pulse-Triggered DTI Sequence with Reduced FOV and Coronal Acquisition at 3T for the Assessment of the Cervical Spinal Cord in Patients with Myelitis

“…9 We observed lower FA and higher MD values in patients with chronic myelitis, as previously reported. 30 Decrease in the FA values may reflect the degree of microstructural disorganization of the spinal cord, suggesting either local extracellular edema or a smaller number of fibers matching a larger extracellular space or both. 9 In addition, radial diffusivity may serve as a marker of overall tissue integrity within chronic MS lesions.…”