Role of MRI Diffusion Tensor Imaging in Assessment of Normal Appearing White Matter in Cases of Multiple Sclerosis
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- Category: Vol. 84, December 2016
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Role of MRI Diffusion Tensor Imaging in Assessment of Normal Appearing White Matter in Cases of Multiple Sclerosis, AMR O. AZAB, HATEM M. SAMIR, AYMAN A. EL-BASMY and FADY M. SHAKER
Abstract
Background: Multiple sclerosis (MS) is an inflammatory demyelinating condition of the central nervous system (CNS) that is generally considered to be autoimmune in nature. White matter tracts are affected, including those of the cerebral hemispheres, infratentorium, and spinal cord. MS lesions, known as plaques, may be detected anywhere in the white matter with resulting diverse clinical presentations. Continuing lesion formation in MS often leads to physical disability and, sometimes, cognitive decline. Several methods have been proposed, mainly using conventional MR modalities like T1, FLAIR or T2 images and enhanced MRI to delineate lesions. Conventional MR techniques cannot give detailed information about the integrity and location of WM tracts. Enhanced MRI is reported as the most sensitive measure of short-term MS activity and is widely used to monitor disease evolution, either natural or modified by treatment. Diffusion MRI is one of the non-conventional MRI techniques used for assessment of multiple sclerosis. The emergence of diffusion tensor imaging (DTI) is of great interest in MS. DTI probe the details of water diffusion within tissues, and could therefore reveal alterations in normal appearing white matter fibers before being visible in conventional MRI. Fractional anisotropy (FA), is the measure of the portion of the diffusion tensor that results from anisotropy (i.e, a measure of the directionality of the molecular motion of water).
Aim of the Work: To evaluate the role of DTI in the examination of the brain white matter that shows normal appearance on conventional MRI sequences in patients with MS, thus assessing its ability to detect early abnormalities at diffusion level.
Patients and Methods: The study included 50 patients 42 females and 8 males having MS (between 20 and 40 years of age) referred from Neurologists to Radiodiagnosis Department at Cairo University Hospitals with 10 age matched healthy control volunteers (between January 2012 and January 2015). Each patient included in the study was subjected to full history taking, reviewing medical sheet and MR examination includ-ing: Conventional MR examination and Diffusion Tensor imaging. Technique was performed using a standard 1.5 Tesla unit (Gyroscan T10 NT, Philips).