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Neuroradiology. 2017 Jul;59(7):655-664. doi: 10.1007/s00234-017-1849-4. Epub 2017 Jun 5.

Magnetic resonance imaging perfusion is associated with disease severity and activity in multiple sclerosis.

Author information

1
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Kirkeveien 166, P.O. Box 4956 Nydalen, N-0424, Oslo, Norway. piotr.sowa@medisin.uio.no.
2
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. piotr.sowa@medisin.uio.no.
3
Department of Neurology, Oslo University Hospital, Oslo, Norway.
4
Intervention Center, Oslo University Hospital, Oslo, Norway.
5
Department of Physics, University of Oslo, Oslo, Norway.
6
Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
7
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
8
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Kirkeveien 166, P.O. Box 4956 Nydalen, N-0424, Oslo, Norway.
9
Department of Life Sciences and Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.

Abstract

PURPOSE:

The utility of perfusion-weighted imaging in multiple sclerosis (MS) is not well investigated. The purpose of this study was to compare baseline normalized perfusion measures in subgroups of newly diagnosed MS patients. We wanted to test the hypothesis that this method can differentiate between groups defined according to disease severity and disease activity at 1 year follow-up.

METHODS:

Baseline magnetic resonance imaging (MRI) including a dynamic susceptibility contrast perfusion sequence was performed on a 1.5-T scanner in 66 patients newly diagnosed with relapsing-remitting MS. From the baseline MRI, cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were generated. Normalized (n) perfusion values were calculated by dividing each perfusion parameter obtained in white matter lesions by the same parameter obtained in normal-appearing white matter. Neurological examination was performed at baseline and at follow-up approximately 1 year later to establish the multiple sclerosis severity score (MSSS) and evidence of disease activity (EDA).

RESULTS:

Baseline normalized mean transit time (nMTT) was lower in patients with MSSS >3.79 (p = 0.016), in patients with EDA (p = 0.041), and in patients with both MSSS >3.79 and EDA (p = 0.032) at 1-year follow-up. Baseline normalized cerebral blood flow and normalized cerebral blood volume did not differ between these groups.

CONCLUSION:

Lower baseline nMTT was associated with higher disease severity and with presence of disease activity 1 year later in newly diagnosed MS patients. Further longitudinal studies are needed to confirm whether baseline-normalized perfusion measures can differentiate between disease severity and disease activity subgroups over time.

KEYWORDS:

Disease activity; Disease severity; Magnetic resonance imaging; Mean transit time; Multiple sclerosis; Perfusion-weighted imaging

PMID:
28585082
DOI:
10.1007/s00234-017-1849-4
[Indexed for MEDLINE]

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