RT Journal Article
SR Electronic
T1 Comparison of MS clinical phenotypes using conventional and magnetization transfer MRI
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 588
OP 588
DO 10.1212/WNL.52.3.588
VO 52
IS 3
A1 M. Filippi
A1 G. Iannucci
A1 C. Tortorella
A1 L. Minicucci
A1 M.A. Horsfield
A1 B. Colombo
A1 M.P. Sormani
A1 G. Comi
YR 1999
UL http://n.neurology.org/content/52/3/588.abstract
AB Objective: To identify differences in pathology between the principal clinical phenotypes of MS using conventional and magnetization transfer (MT) MRI. Methods: T1-weighted and T2-weighted images as well as MT scans were obtained from 20 controls, 21 patients presenting with clinically isolated syndromes suggestive of MS, and 93 MS patients with relapsing-remitting, secondary progressive, benign, or primary progressive course. Metrics considered: hypointense T1 and T2 lesion volumes, average lesion MT ratio, average brain MT ratio, peak height and position from MT histograms. Results: MS patients had lower MT metrics than controls. Patients with clinically isolated syndromes had MT measures similar to controls, whereas primary progressive MS patients had lower histogram peak height with normal peak position. Relapsing-remitting MS patients had lower MT measures, higher T2 lesion load and ratio of hypointense T1 to T2 lesion volumes than patients with clinically isolated syndromes, and lower MT ratio and peak height than benign MS patients. Benign MS patients were similar to controls and patients with clinically isolated syndromes. Secondary progressive MS patients had the lowest MT measures and highest lesion loads. Conclusions: Pathology in patients with clinically isolated syndromes is confined to modest tissue damage in the lesions seen on T2-weighted scans. Severe damage is important for the later development of disability. However, microscopic damage in normal-appearing white matter may be a major contributor to disability in primary progressive MS.