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AJNR - American Journal of Neuroradiology

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Combined Magnetization Transfer and Proton Spectroscopic Imaging in the Assessment of Pathologic Brain Lesions in Multiple Sclerosis

G. Bruce Pike^,a, Nicola de Stefano^a, Sridar Narayanan^a, Gordon S. Francis^a, Jack P. Antel^a and Douglas L. Arnold^a

^a From the McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Canada (G.B.P., S.N., G.F., J.P.A., D.L.A.); and the Department of Neurology, University of Siena, Italy (N.D.S.).

View larger version (115K): [in a new window]   FIG 1. A–F, T1-weighted (A), T2-weighted (B), proton density–weighted (C), MTR (D), and NAA/Cr (E) spectroscopic images of a patient with MS acquired using the protocol presented in the Table; also shown is the classified lesion map for this section (F).

View larger version (14K): [in a new window]   FIG 2. A and B, Mean (per patient) lesional MTR versus NAA/Cr for the entire cohort of patients with MS (A) and the relapsing-remitting subgroup (B) (circles indicate relapsing-remitting group; plus signs, primary progressive; diamonds, secondary progressive). Linear regression lines are plotted for both data sets, but the correlation was significant only for the relapsing-remitting subgroup (solid line in B; rS = .70; P = .016)

View larger version (15K): [in a new window]   FIG 3. A and B, Mean (per patient) MTR versus NAA/Cr in new lesions (<6 months old) for the entire cohort of patients with MS (A) and the relapsing-remitting subgroup (B) (circles indicate relapsing-remitting group; plus signs, primary progressive; diamonds, secondary progressive). The solid lines represent the linear regressions, and the corresponding rank correlations were rS = .44, P = .015 (A) and rS = .81, P = .002 (B)

View larger version (25K): [in a new window]   FIG 4. A and B, Mean (per MRSI voxel) MTR versus NAA/Cr in all MRSI voxels containing more than 25% lesion and less than 10% ventricle for the entire cohort of patients with MS (A) and the relapsing-remitting subgroup (B) (circles indicate relapsing-remitting group; plus signs, primary progressive; diamonds, secondary progressive). The solid lines represent the linear regressions corresponding to linear correlations of rP = .27, P < .0001 (A) and rP = .45, P < .0001 (B)