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ARTICLE

Mean Diffusivity and Fractional Anisotropy Histograms of Patients with Multiple Sclerosis

Mara Cercignania, Matilde Inglesea, Elisabetta Pagania, Giancarlo Comia and Massimo Filippi,a

a From the Neuroimaging Research Unit (M.C., M.I., E.P., M.F.) and the Clinical Trials Unit (G.C.), Department of Neuroscience, Scientific Institute Ospedale San Raffaele and University Milan, Milan, Italy.

BACKGROUND AND PURPOSE: Compared with conventional T2-weighted MR imaging, diffusion tensor MR imaging provides quantitative indices with increased specificity to the most destructive aspects of multiple sclerosis. In this study, we obtained brain mean diffusivity (D) and fractional anisotropy histograms of patients with multiple sclerosis to compare them with those of healthy volunteers and to investigate the correlation between diffusion tensor MR imaging histogram-derived measures and the level of disability and quantities derived from conventional MR imaging.

METHODS: Dual-echo and diffusion tensor MR images were obtained from 78 patients with relapsing-remitting, secondary progressive, or primary progressive multiple sclerosis and from 20 healthy control volunteers. After obtaining mean diffusivity (D) and fractional anisotropy images and image coregistration, D and fractional anisotropy histograms were created. From each histogram, the following measures were derived: the average D and fractional anisotropy, the histogram peak heights, and the histogram peak locations.

RESULTS: All the D and fractional anisotropy histogram-derived measures were different between patients and controls at a significance level of P < .001. No differences were found in any of the considered quantities among the three multiple sclerosis phenotypes. In patients with relapsing-remitting multiple sclerosis, disability was correlated with histogram average D (r = 0.4, P = .01) and peak height (r = -0.4, P = .01). In patients with secondary progressive multiple sclerosis, disability was correlated with fractional anisotropy histogram peak position (r = -0.6, P = .01). Significant correlations were also found between T2 lesion load and various diffusion tensor MR quantities.

CONCLUSION: This study shows that brain D and fractional anisotropy histograms are different for patients with multiple sclerosis compared with control volunteers. This study also shows that quantities derived from diffusion tensor MR imaging are correlated with disability in patients with relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis, suggesting that they might serve as additional measures of outcome when monitoring multiple sclerosis evolution in these patients.




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