Short-term evolution of spinal cord damage in multiple sclerosis: a diffusion tensor MRI study

• Published in: Neuroradiology 2012-10, Vol.54 (10), p.1171-1178
• Main Authors: Théaudin, M., Saliou, G., Ducot, B., Deiva, K., Denier, C., Adams, D., Ducreux, D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anisotropy; Biological and medical sciences; Diffusion coefficient; Diffusion Magnetic Resonance Imaging - methods; Evolution; Female; Functional Neuroradiology; Fundamental and applied biological sciences. Psychology; Human; Humans; Imaging; Inflammation; Intravenous administration; Investigative techniques, diagnostic techniques (general aspects); Learning. Memory; Magnetic resonance imaging; Male; Medical sciences; Medicine; Medicine & Public Health; Memory; Middle Aged; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - diagnosis; Multiple Sclerosis - drug therapy; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system; Neuroimaging; Neurology; Neuroradiology; Neurosciences; Neurosurgery; NMR; Nuclear magnetic resonance; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Reproducibility of Results; Sensitivity and Specificity; Spinal cord; Spinal Cord Diseases - diagnosis; Spinal Cord Diseases - etiology; Spinal Cord Diseases - prevention & control; Steroid hormones; Steroids - therapeutic use; Treatment Outcome; Young Adult
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-012-1057-1

Introduction The potential of diffusion tensor imaging (DTI) to detect spinal cord abnormalities in patients with multiple sclerosis has already been demonstrated. The objective of this study was to apply DTI techniques to multiple sclerosis patients with a recently diagnosed spinal cord lesion, in order to demonstrate a correlation between variations of DTI parameters and clinical outcome, and to try to identify DTI parameters predictive of outcome. Methods A prospective single-centre study of patients with spinal cord relapse treated by intravenous steroid therapy was made. Patients were assessed clinically and by conventional MRI with DTI sequences at baseline and at 3 months. Results Sixteen patients were recruited. At 3 months, 12 patients were clinically improved. All but one patient had lower fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values than normal subjects in either inflammatory lesions or normal-appearing spinal cord. Patients who improved at 3 months presented a significant reduction in the radial diffusivity ( p  = 0.05) in lesions during the follow-up period. They also had a significant reduction in the mean ADC ( p  = 0.002), axial diffusivity ( p  = 0.02), radial diffusivity ( p  = 0.02) and a significant increase in FA values ( p  = 0.02) in normal-appearing spinal cord. Patients in whom the American Spinal Injury Association sensory score improved at 3 months showed a significantly higher FA ( p  = 0.009) and lower radial diffusivity ( p  = 0.04) in inflammatory lesion at baseline compared to patients with no improvement. Conclusion DTI MRI detects more extensive abnormalities than conventional T2 MRI. A less marked decrease in FA value and more marked decreased in radial diffusivity inside the inflammatory lesion were associated with better outcome.