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AJNR - American Journal of Neuroradiology

Publication Preview: Published October 22, 2009

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1839

BRAIN

Diffusely Abnormal White Matter in Progressive Multiple Sclerosis: In Vivo Quantitative MR Imaging Characterization and Comparison between Disease Types

H. Vrenken, A. Seewann, D.L. Knol, C.H. Polman, F. Barkhof and J.J.G. Geurts

From the Departments of Radiology (H.V., J.J.G.G.), Physics and Medical Technology (H.V.), Neurology (A.S., C.H.P.), Epidemiology and Biostatistics (D.L.K., F.B.), and Pathology (J.J.G.G.), MS Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.

Please address correspondence to H. Vrenken, MD, Departments of Radiology and Physics and Medical Technology, VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, the Netherlands; e-mail: H.Vrenken{at}vumc.nl

BACKGROUND AND PURPOSE: Recent postmortem studies in MS brain suggest that the severity of changes in DAWM can be measured by using quantitative MR imaging. This study aimed to characterize DAWM in vivo by using 4 quantitative MR imaging measures and to explore differences between MS disease types.

MATERIALS AND METHODS: In 17 patients with chronic MS (7 PP, 10 SP), quantitative MR imaging was performed at 1.5T, yielding whole-brain voxelwise maps of T1, MTR, ADC, and FA. ROIs were placed to obtain values for DAWM, NAWM, and WM lesions. A general linear mixed-model analysis was used to compare T1, MTR, ADC, and FA between tissue types and disease types.

RESULTS: Values of T1, MTR, ADC, and FA for DAWM were intermediate to those observed in NAWM and WM lesions. In patients with SPMS, DAWM was significantly different from both WM lesions and NAWM regarding all 4 measures, while in patients with PPMS, DAWM differed significantly from NAWM regarding T1, MTR, and FA and from lesions only regarding FA. Most interesting, DAWM differed between disease types: DAWM in patients with SPMS exhibited significantly higher T1 and lower MTR than did DAWM in patients with PPMS.

CONCLUSIONS: In vivo T1, MTR, ADC, and FA reflect the variable severity of pathologic changes in DAWM in MS. Moreover, these quantitative MR imaging measures suggest that DAWM may differ between PPMS and SPMS.

Abbreviations: WM, white matter