Wiley, Journal of Magnetic Resonance Imaging, 1(30), p. 25-34, 2009
DOI: 10.1002/jmri.21817
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Purpose To examine the T2-normal appearing spinal cord of patients with multiple sclerosis (MS) using diffusion tensor imaging. Materials and Methods Diffusion tensor images of the spinal cord were acquired from 21 healthy subjects, 11 MS patients with spinal cord lesions, and 10 MS patients without spinal cord lesions on the T2-weighted MR images. Different diffusion measures were evaluated using both a region of interest (ROI) -based and a diffusion tensor tractography-based segmentation approach. Results It was observed that the FA, the transverse diffusivity , and the ratio of the longitudinal and transverse diffusivities (/ ) were significantly lower in the spinal cord of MS patients with spinal cord lesions compared with the control subjects using both the ROI method (P = 0.014, P = 0.028, and P = 0.039, respectively) and the tractography-based approach (P = 0.006, P = 0.037, and P = 0.012, respectively). For both image analysis methods, the FA and the / values were significantly different between the control group and the MS patient group without T2 spinal cord lesions (P = 0.013). Conclusion Our results suggest that the spinal cord may still be affected by MS, even when lesions are not detected on a conventional MR scan. In addition, we demonstrated that diffusion tensor tractography is a robust tool to analyze the spinal cord of MS patients