To investigate diffusional changes in multiple sclerosis ms plaques and nongaussian behavior of water diffusion by using diffusional kurtosis imaging dki. Imaging surrogates of disease activity in neuromyelitis. This study aimed to determine cerebral correlates of depression in multiple sclerosis patients using diffusion tensor imaging. Further, it summarizes the clinical role of dti in various disease processes such as amyotrophic lateral sclerosis, multiple sclerosis, parkinsons. Quantitative analysis of dti data were performed using leonardo vd10b software on a syngo vx49b imaging software platform siemens. Diffusion tensor imaging dti was performed in 45 consecutive ms patients and. Region of interest roi was delineated as white matter wm in controls and ms plaques and wm in. Cureus white matter evaluation in multiple sclerosis. Distribution of cortical diffusion tensor imaging changes in multiple sclerosis. To measure anisotropy, we calculated ra, as previously defined. Ra is defined on a 0 equal diffusion in all directions to 1 diffusion in only one direction interval. The mlg software do not capture nonessential activities such as menu items and listings you click on or pages viewed.
Diffusion tensor imaging findings in the multiple sclerosis patients and their. Multiple sclerosis ms is a relatively common acquired chronic relapsing demyelinating disease involving the central nervous system, and is the second most common cause of neurological impairment in young adults, after trauma 19. We investigated the possible statistically significant variation of md and fa in different ms patients, compared simultaneously, putting in comparison their normal appearing white matter nawm and white matter affected by disease. We performed dti in 23 als patients who had two magnetic resonance imaging mri scans at 6 month intervals and to correlate results with clinical features. Diffusion tensor imaging in multiple sclerosis at different. Diffusion tensor magnetic resonance imaging in multiple. Background diffusion tensor imaging dti has been suggested as a potential biomarker. In this issue of the ajnr, castriotascanderberg et al page 862 describe the diffusion weighted imaging dwi findings from 10 patients with relapsingremitting multiple sclerosis ms, 10 patients with secondaryprogressive ms, and 11 control subjects. Diffusionweighted imaging and demyelinating diseases. Directional diffusion tensor imaging in multiple sclerosis. Evaluation of patients with relapsingremitting multiple sclerosis.
Multiple sclerosis and diffusion tensor imaging radiology. The research paper, titled diffusion tensor imaging identifies aspects of therapeutic estrogen receptor. While diffusion tensor imaging is useful for the study of anisotropic systems such. The application of dti in multiple sclerosis ms has yielded noteworthy results. Adc was calculated as the average of the three diagonal diffusion tensor elements. Distribution of cortical diffusion tensor imaging changes in multiple. Diffusionweighted mr imaging of multiple sclerosis. Conventional magnetic resonance imaging mri is sensitive to some, but not all, brain changes associated with ms. It is used to study the white matter architecture and integrity of the normal and diseased brains multiple sclerosis, stroke, aging, tumors, dementia, schizophrenia, etc.
Supplement to longitudinal highdimensional principal components analysis with application to diffusion tensor imaging of multiple sclerosis. Diffusion tensor imaging of the cervical spinal cord of patients with relapsingremising multiple sclerosis. Multiple white matter tract abnormalities underlie cognitive impairment in rrms. Twentytwo patients were treated with pioglitazone or placebo and monitored by diffusion tensor imaging dti at baseline and after 12 months. Diffusion tensor imaging of corpus callosum integrity in.
Magnetic resonance mr imaging observations have convincingly indicated that cortical atrophy is an early, widespread, and clinically relevant phenomenon in ms 3, 4. Diffusion tensor imaging dti, a form of dwi, is useful when a tissue, such as the neural axons of white matter in the brain, has an internal fibrous structure that allows water to diffuse. With the implementation of diffusion tensor imaging dti, it is. Although diffusion tensor imaging has not yet been able to match. Effects of pioglitazone on diffusion tensor imaging. Magnetization transfer imaging is the more established of the two techniques in ms research, and its findings have. Diffusion tensor imaging for characterizing white matter changes in. Dt mr imaging data collection places high demands on scanner hardware and, though the acquisition and postprocessing can be relatively straightforward. In order to enhance the detection of diffuse pathological alterations associated with advanced ms, several methodologies have been applied. Diffusion tensor imaging provides much more data about the condition of the brain than a conventional mri, allowing a doctor to clearly see areas of concern.
For routine dw imaging we often ignore this complexity and reduce diffusion to a single average value, the apparent diffusion coefficient adc, but this is overly. The statistically significant correlation between asymmetric functional deficits, shown in electrophysiology and asymmetric structural abnormalities by using diffusion tensor imaging, suggests that. The two multiple sclerosis patients in the present study that were misclassified as neuromyelitis optica by our new discriminant function both had dawsons finger type lesions and therefore would have satisfied the conventional imaging criteria for multiple sclerosis. Software improvements include novel pulse sequence designs and advanced image. Diffusion tensor imaging dti is a powerful quantitative technique with the potential to detect in vivo microscopic abnormalities of brain tissue. Louis delaram farzanfar, university of toronto joanna jeon, university of virginia shivangi mistry, university of virginia ainslee neu, university of minnesota katie santo, university of minnesota tinashe tapera, drexel university. Diffusion tensor imaging abnormalities in depressed. Objective to use diffusion basis spectrum imaging dbsi to assess how damage to normalappearing white matter nawm in the corpus callosum cc influences neurologic impairment in people with ms pwms. It allows the mapping of the diffusion process of molecules, mainly water, in biological tissues, in vivo and noninvasively. In particular, diffusion tensor imaging dti 2, which best describes the diffusion properties of a living tissue, has been employed to investigate the structural damage. Diffusion tensor imaging dti has been demonstrated to have the potential to identify occult changes in ms lesions. Diffusiontensor imaging and double inversion recovery can be combined to analyze the structural changes occurring in cortical lesions and normalappearing gray matter in multiple sclerosis ms.
Fractional anisotropy of cortical lesions and normalappearing gray matter in multiple sclerosis patients was higher at baseline than in. Diffusion tensor imaging abnormalities in depressed multiple. Multiple sclerosis ms, a demyelinating disease, occurs principally in the white matter wm of the central nervous system. Diffusion tensor imaging and disability progression in multiple.
Diffusion tensor imaging dti is a sensitive mri technique for detecting structural tissue damage in the brain and spinal cord. Multiple sclerosis ms is a complex disease of the cns. It has been successfully applied to study the occult damage in multiple sclerosis ms and neuromyelitis optica nmo, providing information otherwise inaccessible on the pathological substrates. Multiple sclerosis ms is an inflammatory disease of the central. To measure anisotropy, we calculated ra, as previously defined 1. Multiple sclerosis ms is the most common inflammatory.
Diffusion tensor imaging dti a new imaging technique. We aimed to investigate the relations between cc microstructure integrity as measured by diffusion tensor imaging dti in relapsing. Assessment of white matter tract damage in patients with amyotrophic. We recommend adding quantitative diffusion tensor imaging to the other routine sequences for diagnosis and follow up of multiple sclerosis patients. Diffusion tensor imaging dti has been demonstrated to have the potential to identify. Overview of diffusion tensor imaging in multiple sclerosis. Mar 25, 2020 this medical imaging technique is also used in diagnosis, especially when stroke or multiple sclerosis are suspected. Longitudinal tbss analyses of early multiple sclerosis ms using 3 tesla magnetic resonance imaging mri are not common. Nelson, daniel pelletier magnetic resonance science center, department of radiology, university of california, san francisco, san francisco, ca, usa. A quantitative evaluation of damage in normal appearing white matter in patients with multiple sclerosis using diffusion tensor mr imaging at 3 t.
This study was performed to assess changes in diffusion tensor imaging dti over time in patients with amyotrophic lateral sclerosis als. Diffusion tensor imaging for assessment of normally. In this study, it was aimed to use diffusion tensor imaging dti. White matter abnormalities in multiple sclerosis evaluated by.
The purpose of this study was to evaluate the role of diffusion tensor imaging examination of the normalappearing white matter of the brain and spinal cord in patients with multiple sclerosis and to determine the relationship between diffusion tensor imaging metrics and patients clinical status. Axial dti of the cervical spinal cord was performed in 24 patients with rrms and 24 age and sexmatched control subjects. Magnetic resonance diffusion tensor imaging for occult. Diffusion tensor imaging for characterizing white matter. Sep 27, 2012 diffusion tensor imaging dti has become one of the most popular mri techniques in brain research, as well as in clinical practice. Diffusion tensor imaging in ms diffusion weighted imaging is a new mri technique which has been widely applied in ms to improve our understanding of the disease. We also recommend the other longstanding study for evaluation using diffusion tensor imaging for monitoring disease progression and treatment response. Diffusivity in the core of chronic multiple sclerosis lesions plos. However, the pathological substrates that underpin alterations in brain tissue diffusivity are not yet fully delineated. Effects of pioglitazone on diffusion tensor imaging indices in multiple sclerosis patients. Dualecho and dti scans were obtained from 78 patients with relapsingremitting, secondary progressive, or. Effects of pioglitazone on diffusion tensor imaging indices.
Diffusion tensor imaging uses a mathematical model to calculate fractional anisotropy fa, which is a measure of the degree of diffusion anisotropy. The aim of this study was to evaluate diffusion tensor imaging dti indices in the corpus callosum and pyramidal tract in normalappearing white matter nawm and the caudate nucleus and thalamus in deep grey matter nadgm in all ms subtypes and clinically isolated syndrome cis. Mar 23, 2020 usefulness of diffusion tensor imaging findings as biomarkers for amyotrophic lateral sclerosis. Two tensor derived rotational invariants relative anisotropy ra and apparent diffusion coefficient adc were saved for subsequent analysis. Methods using standard mri, the primary pathologies in ms of axonal injuryloss, demyelination, and inflammation are not differentiated well. An fa value close to 1 indicates the highest diffusion anisotropy, as found in white matter tracts, which restricts water diffusion to one prominent direction. Magnetic resonance diffusion tensor imaging for occult lesion. Usefulness of diffusion tensor imaging findings as biomarkers. Janve dissertation submitted to the faculty of the graduate school of vanderbilt university, nashville, tennessee in partial fulfillment of the requirements for the degree of doctor of philosophy in physics may, 2015 nashville, tennessee approved. A diffusion tensor imaging software comparison and. Despite this similarity, it is evident clinically that the accumulation of disability in patients with neuromyelitis optica is relapse related and that a progressive phase is very uncommon. High resolution diffusion tensor imaging of axonal damage. The target was white matter tracts in multiple sclerosis, based on the. Corpus callosum cc is frequently involved in multiple sclerosis ms.
Current clinical applications of diffusiontensor imaging in. Dti diffusion tensor imaging at 3 tesla was used to evaluate 106. Cortical diffusiontensor imaging abnormalities in multiple sclerosis. Longitudinal tbss analyses of early multiple sclerosis ms using 3 tesla. Diffusionweighted imaging dwi provides information about water diffusion in tissue and diffusion tensor mri dtmri about fiber direction. Diffusion tensor imaging of multiple sclerosis along the corpus.
It is used to study the white matter architecture and integrity of the normal and diseased brains multiple sclerosis. Cortical diffusiontensor imaging abnormalities in multiple. Biological tissues are highly anisotropic, meaning that their diffusion rates are not the same in every direction. Diffusion tensor mr imaging and magnetization transfer imaging are two promising advances that can provide a means for assessing important physiologic parameters eg, demyelination, axonal loss in multiple sclerosis ms that cannot be directly assessed at standard mr imaging. Depression is common in patients with multiple sclerosis, but to date no studies have explored diffusion tensor imaging indices associated with mood change. Diffusion tensor imaging and disability progression in. Diffusion tensor imaging of occult injury of optic. To use magnetic resonance diffusion tensor imaging dti to estimate degrees of demyelination and axonal degeneration in the corpus callosum cc in cases of ms with different final outcomes. Inflammatory demyelinating lesions of the central nervous system are a common feature of both neuromyelitis optica and multiple sclerosis. Temporal dynamics of diffusion metrics in early multiple.
This poses the question whether there is any pathological evidence. We provide extra figures and tables summarizing the results of simulation studies and the analysis of dti images of ms patients. Diffusion tensor image in neurology osama ragab neurology md. Our objectives were to determine the reproducibility of diffusion tensor imaging dti in volunteers and to evaluate the ability of the method to monitor longitudinal changes occurring in the normalappearing white matter nawm of patients with multiple sclerosis ms. Diffusion tensor imaging dti has become one of the most popular mri techniques in brain research, as well as in clinical practice.
Comparisons of diffusion tensor imaging between amyotrophic lateral sclerosis als and normal controls. Diffusion tensor imaging in an animal model of multiple sclerosis by vaibhav a. To evaluate whether diffusiontensor imaging can be combined with double. Diffusion imaging is a quantitative, mrbased technique potentially useful for the study of multiple sclerosis ms, due to its increased pathologic specificity over conventional mri and its ability to assess in vivo the presence of tissue damage occurring outside t2visible lesions, i. Diffusion tensor imaging for assessment of normally appearing.
In 1826 a botanist named robert brown was studying the seemingly random pattern of motion that pollen grains exhibited when suspended in water through his microscope. Evaluation of the spinal cord is important in the diagnosis and followup of patients with multiple sclerosis. Diffusion tensor imaging in nawm and nadgm in ms and cis. Gratsias g, kapsalaki e, kogia s, dardiotis e, tsimourtou v, lavdas e, kousi e, pelekanou a, hadjigeorgiou gm and fezoulidis i. To apply a novel postprocessing voxelbased analysis for diffusion tensor imaging of the cervical spinal cord in multiple sclerosis ms in a prospective crosssectional study. Pdf distribution of cortical diffusion tensor imaging. Spinal cord diffusiontensor imaging and motorevoked. To quantify, using diffusion tensor imaging dti, the tissue damage in lesions and normalappearing white matter nawm from a large cohort of patients with ms and to investigate the magnitude of the correlation between dtiderived metrics and clinical disability. Dti abnormalities, which are already detectable in patients with clinically isolated syndrome cis, become more pronounced as disease duration and neurological impairment increase.
Diffusion tensor imaging and double inversion recovery can be combined to analyze the structural changes occurring in cortical lesions and normalappearing gray matter in multiple sclerosis ms. Diffusionweighted magnetic resonance imaging dwi or dwmri is the use of specific mri sequences as well as software that generates images from the resulting data that uses the diffusion of water molecules to generate contrast in mr images. Demyelinating plaques, as seen in multiple sclerosis, cause destruction of white matter fibers which is manifested on diffusion tensor imaging dti as increased diffusivity of water molecules. The dti data were analyzed with commercial neuro 3d software. Analysis of normalappearing white matter in multiple. Diffusion tensor imaging dti is one of the most widely used methods in detecting microstructural abnormalities based on water diffusion measures with the assumption that the. Diffusion imaging in multiple sclerosis request pdf. Diffusion tensor imaging in multiple sclerosis at different final outcomes. Multiple sclerosis ms is a chronic disorder of the cns, characterized by focal white matter wm plaques along with diffuse normal appearing wm nawm damage and cortical demyelination. Diffusion tensor imaging dti is an effective means of quantifying parameters of demyelination and axonal loss.
Temporal dynamics of diffusion metrics in early multiple sclerosis. Diffusion tensor imaging of occult injury of optic radiation. This study evaluated patients with multiple sclerosis using diffusion tensor imaging dti to obtain fractional anisotropy fa and mean diffusivity md values. This medical imaging technique is also used in diagnosis, especially when stroke or multiple sclerosis are suspected. We have previously applied postmortem pm diffusion imaging to the investigation of the relationship between cortical histology measures and white matter diffusion properties kolasinski et al. Diffusiontensor imaging dti is a noninvasive medical imaging tool used to investigate the. Diffusion tensor imaging dti is one of the most widely used methods. Objectives diffusion tensor imaging dti has been suggested as a new promising tool in ms that may provide greater pathological specificity than conventional mri, helping, therefore, to elucidate disease pathogenesis and monitor therapeutic efficacy. Diffusion tensor dt mr imaging has frequently been applied in multiple sclerosis ms because of its ability to detect and quantify diseaserelated changes of the tissue microstructure within and outside t2visible lesions.
Diffusion tensor imaging for multiple sclerosis diagnosis. Histopathologic studies have demonstrated both focal and diffuse pathologic changes in the cortex of patients with multiple sclerosis ms 1, 2. The statistically significant correlation between asymmetric functional deficits, shown in electrophysiology and asymmetric structural abnormalities by. This can be demonstrated by comparing fractional an. Conventional and diffusion tensor imaging robert j. Usefulness of diffusion tensor imaging findings as. The aim of this study is to assess the performance of commonly used parameters derived from dki and diffusion tensor imaging dti in detecting microstructural changes and associated pathology in relapsing remitting ms rrms. Diffusion tensor imaging of multiple sclerosis along the corpus callosum erin denardo, washington university in st. Diffusion weighted imaging dwi provides information about water diffusion in tissue and diffusion tensor mri dtmri about fiber direction. Postprocessing was performed with an inhouse program in matlab. Evaluation of patients with relapsingremitting multiple. Our purpose was to investigate diffusion tensor imaging dti changes in different regions of normalappearing spinal cord nasc in relapsingremitting multiple sclerosis rrms.
Diffusion tensor imaging and disability progression in multiple sclerosis. Diffusion basis spectrum imaging provides insights into ms. Diffusion weighted imaging dwi is a magnetic resonance imaging mri method that produces in vivo images of biological tissues weighted with the local microstructural characteristics of water diffusion. European committee for treatment and research in multiple sclerosis.
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