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Analysis of Normal-Appearing White Matter in Multiple Sclerosis: Comparison of Diffusion Tensor MR Imaging and Magnetization Transfer Imaging

Alexander C. Guoa, Valerie L. Jewellsa and James M. Provenzalea

a From the Department of Radiology, Duke University Medical Center, Durham, NC.



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  		FIG 1. Axial MR images in a 42-year-old patient with MS.

A, T2-weighted image (2800/100/2) obtained at the level just above the roof of lateral ventricles shows some of the ROIs used. ROI labeled 1 overlies a plaque in the right centrum semiovale. ROI labeled 2 overlies a matching WM region in the left centrum semiovale. Arrow indicates a second plaque located more posteriorly.

B, Diffusion tensor MR image–derived anisotropy map obtained by using single-shot spin-echo echo-planar imaging (12,000/107/2200/1, b = 1000 s/mm2 in six directions, and b = 0) at the same anatomic level as in A shows placement of ROIs on the same structures as in A. The second plaque in A is bracketed by the arrows on this image.

C, Diffusion tensor MR image–derived ADC map obtained by using single-shot spin-echo echo-planar imaging with (12,000/107/2200/1, b = 1000 s/mm2 in six directions, and b = 0) at the same anatomic level as in A shows placement of ROIs on the same structures as in A. The second plaque in A is bracketed by the arrows on this image.

D, Proton density–weighted image (2800/30/2) obtained at the same anatomic level as in A, before the application of magnetization transfer saturation pulse, shows an ROI labeled 1 overlying a plaque in the right centrum semiovale and an ROI labeled 2 overlying a matching WM region in the left centrum semiovale (normal-appearing WM regions remote from plaques). Arrow indicates a second plaque located more posteriorly.

E, Proton density–weighted image (2800/30/2) obtained at the same anatomic level as in A, after the application of magnetization transfer saturation pulse with an offset frequency of 1000 Hz, shows an ROI labeled 1 overlying a plaque in the right centrum semiovale and an ROI labeled 2 overlying a matching WM region in the left centrum semiovale. Arrow indicates a second plaque located more posteriorly.

F, Same T2-weighted image as in A shows additional ROIs labeled 1, 2, 3, and 4 overlying normal-appearing PWM regions in the right centrum semiovale.

G, Same T2-weighted image as in A, without ROIs, shows plaques 1 (straight arrow) and 2 (curved arrow) in A.

H, Same diffusion tensor MR image–derived anisotropy map as in B, obtained at the same anatomic level as in G, shows the areas of signal intensity abnormality in the right centrum semiovale corresponding to the first (short arrows) and second (long arrows) plaques in G.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X