Comparison of T2 lesion volume and magnetization transfer ratio histogram analysis and of atrophy and measures of lesion burden in patients with multiple sclerosis.

PURPOSE The purpose of this study was twofold: first, to compare two different measures of lesion burden in patients with multiple sclerosis (MS), the magnetization transfer ratio (MTR) histogram and T2 lesion volume; and, second, to investigate the relationship between lesion burden and atrophy in patients with MS. METHODS Thirty patients with MS were examined with MR imaging, including fast spin-echo T2- and proton density-weighted sequences as well as magnetization transfer sequences. The lesion burden in each subject was quantitated by MTR histographic analysis and by a computer-based method for calculating the total volume of lesions on T2-weighted images. Additionally, the CSF volume, the brain parenchymal volume, and the percentage of brain parenchymal volume were determined in all patients by using this method and were compared with measurements in eight control subjects. RESULTS Significant loss of parenchymal volume was seen in patients with MS as determined by increased CSF volume and decreased percentage of brain parenchymal volume relative to that in age-matched control subjects. An inverse correlation was observed between the peak height of the MTR histogram and T2 lesion volume. T2 lesion volume corresponded positively with CSF volume and inversely with percentage of brain parenchymal volume. The peak height of the MTR histogram corresponded positively with percentage of brain parenchymal volume and inversely with CSF volume. CONCLUSION MS patients sustain a significant loss of parenchymal volume (atrophy), which corresponds strongly with increasing lesion burden. T2 lesion volume and peak height of the MTR histogram show good correlation, and the peak height of the MTR histogram shows a superior correlation with measures of brain atrophy as compared with measurements of T2 lesion volume, suggesting that the MTR histogram may be a better indicator of global disease burden than is T2 lesion volume.

[1]  R I Grossman,et al.  Microscopic disease in normal-appearing white matter on conventional MR images in patients with multiple sclerosis: assessment with magnetization-transfer measurements. , 1995, Radiology.

[2]  I. Allen,et al.  A histological, histochemical and biochemical study of the macroscopically normal white matter in multiple sclerosis , 1979, Journal of the Neurological Sciences.

[3]  F. Mastaglia,et al.  Computerized tomography of brain and optic nerve in multiple sclerosis Observations in 100 patients, including serial studies in 16 , 1978, Journal of the Neurological Sciences.

[4]  T. Reisner,et al.  Computerized tomography in multiple sclerosis. , 1980, Archives of neurology.

[5]  M. Netsky,et al.  The pathology of multiple sclerosis. , 1950, Research publications - Association for Research in Nervous and Mental Disease.

[6]  S. Rao,et al.  Cerebral disconnection in multiple sclerosis. Relationship to atrophy of the corpus callosum. , 1989, Archives of neurology.

[7]  R. Kinkel,et al.  Correlations of nuclear magnetic resonance imaging, computerized tomography, and clinical profiles in multiple sclerosis , 1986, Neurology.

[8]  M. Tsolaki,et al.  Correlation of dementia, neuropsychological and MRI findings in multiple sclerosis. , 1994, Dementia.

[9]  R I Grossman,et al.  Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. , 1992, Radiology.

[10]  S. Stöppler,et al.  White matter lesions and cognitive deficits: relevance of lesion pattern? , 1994, Acta neurologica Scandinavica.

[11]  R E Lenkinski,et al.  Correlation of spectroscopy and magnetization transfer imaging in the evaluation of demyelinating lesions and normal appearing white matter in multiple sclerosis , 1994, Magnetic resonance in medicine.

[12]  J A Frank,et al.  Serial contrast‐enhanced magnetic resonance imaging in patients with early relapsing–remitting multiple sclerosis: Implications for treatment trials , 1994, Annals of neurology.

[13]  G. C. Hurst,et al.  Cerebral white matter: technical development and clinical applications of effective magnetization transfer (MT) power concepts for high-power, thin-section, quantitative MT examinations. , 1996, Radiology.

[14]  A J Thompson,et al.  Progressive cerebral atrophy in multiple sclerosis. A serial MRI study. , 1996, Brain : a journal of neurology.

[15]  R H Edwards,et al.  Magnetic resonance relaxation time mapping in multiple sclerosis: normal appearing white matter and the "invisible" lesion load. , 1994, Magnetic resonance imaging.

[16]  R I Grossman,et al.  Dyke Award paper. MR of wallerian degeneration in the feline visual system: characterization by magnetization transfer rate with histopathologic correlation. , 1994, AJNR. American journal of neuroradiology.

[17]  J. Udupa,et al.  A new computer-assisted method for the quantification of enhancing lesions in multiple sclerosis. , 1997, Journal of computer assisted tomography.

[18]  J K Udupa,et al.  Global volumetric estimation of disease burden in multiple sclerosis based on magnetization transfer imaging. , 1997, AJNR. American journal of neuroradiology.

[19]  L A Loizou,et al.  Cranial computed tomography in the diagnosis of multiple sclerosis. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[20]  D. Paty,et al.  Interferon beta‐1b is effective in relapsing‐remitting multiple sclerosis , 1993, Neurology.

[21]  I. Moseley.  Computed tomography and nuclear magnetic resonance imaging of the brain in multiple sclerosis: a review. , 1983, Bulletin de la Societe belge d'ophtalmologie.

[22]  J H Simon,et al.  Quantitative determination of MS-induced corpus callosum atrophy in vivo using MR imaging. , 1987, AJNR. American journal of neuroradiology.

[23]  B E Kendall,et al.  The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. , 1987, Brain : a journal of neurology.

[24]  B. Brownell,et al.  The distribution of plaques in the cerebrum in multiple sclerosis , 1962, Journal of neurology, neurosurgery, and psychiatry.

[25]  Supun Samarasekera,et al.  Multiple sclerosis lesion quantification using fuzzy-connectedness principles , 1997, IEEE Transactions on Medical Imaging.

[26]  Supun Samarasekera,et al.  Fuzzy Connectedness and Object Definition: Theory, Algorithms, and Applications in Image Segmentation , 1996, CVGIP Graph. Model. Image Process..

[27]  M Filippi,et al.  A Magnetization Transfer Imaging Study of Normal-Appearing White Matter in Multiple Sclerosis , 1995, Neurology.

[28]  A. Jennekens‐Schinkel,et al.  Decline of cognition in multiple sclerosis: dissociable deficits. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[29]  F. Barkhof,et al.  Gadolinium enhancement increases the sensitivity of MRI in detecting disease activity in multiple sclerosis. , 1993, Brain : a journal of neurology.

[30]  D. Paty,et al.  CORRELATION BETWEEN NMR SCAN AND BRAIN SLICE DATA IN MULTIPLE SCLEROSIS , 1984, The Lancet.

[31]  G. Comi,et al.  Brain magnetic resonance imaging correlates of cognitive impairment in multiple sclerosis , 1993, Journal of the Neurological Sciences.

[32]  G B Pike,et al.  Measure of magnetization transfer in multiple sclerosis demyelinating plaques, white matter ischemic lesions, and edema. , 1996, AJNR. American journal of neuroradiology.

[33]  G. Paulson,et al.  Magnetic resonance imaging and clinical correlations in multiple sclerosis , 1988, Journal of the Neurological Sciences.

[34]  Supun Samarasekera,et al.  Detection and quantification of MS lesions using fuzzy topological principles , 1996, Medical Imaging.

[35]  J. Oger,et al.  Multiple sclerosis , 1988, Neurology.

[36]  T. Hammeke,et al.  Chronic progressive multiple sclerosis. Relationship between cerebral ventricular size and neuropsychological impairment. , 1985, Archives of neurology.

[37]  D. Silberberg,et al.  New diagnostic criteria for multiple sclerosis: Guidelines for research protocols , 1983, Annals of neurology.

[38]  Dewey Odhner,et al.  3DVIEWNIX: an open, transportable, multidimensional, multimodality, multiparametric imaging software system , 1994, Medical Imaging.

[39]  R O Barnard,et al.  Corpus callosum in multiple sclerosis , 1974, Journal of neurology, neurosurgery, and psychiatry.

[40]  J. Ford,et al.  Magnetic resonance imaging in multiple sclerosis: results in 32 cases. , 1985, AJNR. American journal of neuroradiology.