Intra-observer reproducibility in measuring new putative MR markers of demyelination and axonal loss in multiple sclerosis: a comparison with conventional T2-weighted images

Background and Purpose-We obtained magnetization transfer imaging (MTI) scans from individuals with cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (1) to investigate the presence, extent, and nature of pathology in white and gray matter outside proton density (PD)-visible lesions; (2) to quantify the degree of tissue damage occurring in lesions seen on PD-weighted scans; and (3) to correlate MTI-derived measures of disease burden with age, physical disability, and cognitive performance. Methods-Dual-echo, T1-weighted, and MTI scans of the brain were obtained from 33 individuals with CADASIL and 12 control subjects. Magnetization transfer ratio (MTR) values from PD-visible lesions, normal-appearing white matter (NAWM), and normal-appearing gray matter (NAGM) were measured. Histograms of MTR from the whole brain and normal-appearing brain tissue were also produced. Results-All MTR values from NAWM and NAGM regions studied were significantly lower for individuals with CADASIL than for control subjects, with the exception of those obtained from the NAWM of the infratentorial structures and the NAGM of the occipital cortex. The average MTR from PD lesions in individuals with CADASIL was significantly lower than that from all the NAWM regions. Average MTR and peak location from whole-brain and normal-appearing brain tissue histograms were significantly lower for individuals with CADASIL than for control subjects. MTR values from NAWM were strongly correlated with the extent of macroscopic lesions and their average MTR. Apart from NAGM, average MTR from all other tissues studied significantly decreased with increasing age, physical disability, and cognitive impairment. Conclusions-PD

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“…In previous studies, 26,27 we found very low intraobserver variabilities when we measured all the MRI and MTI quantities mentioned above.…”

Section: Image Review and Quantificationmentioning

confidence: 58%

Correlations Between Clinical Findings and Magnetization Transfer Imaging Metrics of Tissue Damage in Individuals With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Iannucci

Dichgans

Rovaris

et al. 2001

Stroke

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“…26 Thalamic T2 hyperintense lesions were identified. Using T1-weighted images, we estimated baseline normalized brain volume by using SIENAX 27 software (www.fmrib.ox.ac.uk/fsl/ siena) and the percentage of brain volume change by using its longitudinal version.…”

Section: Image Review and Analysismentioning

confidence: 97%

Thalamic Damage Predicts the Evolution of Primary-Progressive Multiple Sclerosis at 5 Years

Mesaroš¹,

Rocca²,

Pagani³

et al. 2011

AJNR Am J Neuroradiol

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“…In contrast to techniques based on regions of interest, this approach cannot provide any information concerning the regional pattern of tissue changes. However, the whole brain histogram analysis is highly reproducible 32,33 and provides easily comparable data for longitudinal studies without any image registration or subjective delineation of anatomic regions. In healthy subjects, Trace(D) histograms are characterized by a unimodal distribution with a narrow peak, indicating that most of the diffusion values measured in the cerebral volume are contained within a small range.…”

Section: Discussionmentioning

confidence: 99%

Monitoring Disease Progression in CADASIL With Diffusion Magnetic Resonance Imaging

Molko

Pappatà

Mangin

et al. 2002

Stroke

116

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Background and Purpose-In cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a large increase in water diffusion has been found both inside and outside the cerebral lesions as detected on conventional MRI. The aim of the present study was to assess the sensitivity of diffusion tensor imaging for monitoring the progression of cerebral tissue damage during the course of CADASIL. Methods-With the use of diffusion tensor imaging, whole brain trace of the diffusion tensor [Trace(D)] histograms were obtained in 22 CADASIL patients and 12 age-matched controls at baseline, in 14 patients after a mean delay of 21 months, and in 5 controls after a mean delay of 29 months. Parameters derived from these histograms (mean value, peak height, and peak location) were analyzed at baseline and during the follow-up. Results-At baseline, all the histogram parameters differed between patients and controls and were found to be significantly correlated with both the Mini-Mental State Examination score and Rankin Scale score in the patient group. The follow-up study showed a decrease in the peak height associated with an increase in the mean value of whole brain Trace(D) histograms in the 14 CADASIL patients scanned twice. The diffusion changes appeared larger in the patients whose Rankin score increased during the study period. Conclusions-These results suggest that the measurement of water diffusion over time is a sensitive marker for the progression of tissue damage in the brain. Thus, quantitative diffusion MRI can be used to monitor disease progression in CADASIL and possibly in other types of small-vessel brain disorders.

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Intra-observer reproducibility in measuring new putative MR markers of demyelination and axonal loss in multiple sclerosis: a comparison with conventional T2-weighted images

Cited by 138 publications

References 23 publications

Correlations Between Clinical Findings and Magnetization Transfer Imaging Metrics of Tissue Damage in Individuals With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Correlations Between Clinical Findings and Magnetization Transfer Imaging Metrics of Tissue Damage in Individuals With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Thalamic Damage Predicts the Evolution of Primary-Progressive Multiple Sclerosis at 5 Years

Monitoring Disease Progression in CADASIL With Diffusion Magnetic Resonance Imaging

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