THE CONTRIBUTION OF DIFFUSION TENSOR IMAGING TO CONVENTIONAL MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF MULTIPLE SCLEROSIS PATIENTS

Abstract

Aim: The aim of this study is to investigate whether anisotropic diffusion is superior to conventional magnetic resonance imaging for understanding the pathophysiology of multiple sclerosis (MS) disease by Fractional anisotropy (FA) measurements. Material and Methods: In our study, FA measurements were made from the plaque, the periplaque area, the normal appeared white matter contralateral to the plaque and normal appearing white matter areas in MS patients and from the normal white matter in the control group. 3D trography maps were made in all MS patients and it was evaluated whether white pathways were affected by MS disease. Results: When the degree of anisotropy was compared to the control group, the degree of plaques was found lowest. Increase was observed in periplaque, the normal appeared white matter contralateral to the plaque and normal appearing white matter, respectively. The active plaque FA value was found to be lower than the chronic plaque FA value, and the chronic plaque FA was found to be lower than the normal white matter FA value. It has been shown that plaques traced along axonal pathways in MS patients cause interruption in axonal pathways. Conclusion: Progressive decrease in anisotropy from normal appearing white matter to periplaque white matter and plaque level indicates myelin damage. This suggests that the white matter that appears normal on T2 images on conventional MR is not actually normal. Based on these results, it was thought that diffusion tensor imaging would be useful in evaluating the burden of disease in MS patients.

Keywords

• Multiple Sclerosis
• Diffusion Tensor Imaging
• Fractional Anisotropy
• Magnetic Resonance Imaging

MULTİPL SKLEROZ HASTALARININ TANISINDA DİFÜZYON TENSÖR GÖRÜNTÜLEMENİN KONVANSİYONEL MANYETİK REZONANS GÖRÜNTÜLEMEYE KATKISI

Abstract

Amaç: Bu çalışmanın amacı Fraksiyonel anizotropi (FA) ölçümleri ile multipl skleroz (MS) hastalığının patofizyolojisini anlamada anizotropik difüzyonun konvansiyonel manyetik rezonans görüntülemeye üstün olup olmadığını araştırmaktır. Gereç ve yöntem: Çalışmamızda MS hastalarında plak, periplak alanı, plağın kontralateralinde normal görünen beyaz cevher ve normal görünen beyaz cevher alanlarından, kontrol grubunda ise normal beyaz cevherden FA ölçümleri yapıldı. Tüm MS hastalarında 3 boyutlu trografi haritaları yapıldı ve beyaz yolakların MS hastalığından etkilenip etkilenmediği değerlendirildi. Bulgular: Anizotropinin derecesi kontrol grubu ile karşılaştırıldığında en düşük değer plakta saptanırken; periplak, plağın karşısında normal görünen beyaz cevher ve normal görünen beyaz cevherde anizotropinin sırasıyla arttığı izlenmiştir. Aktif plak FA, kronik plak FA’dan; kronik plak FA, normal beyaz cevherde FA’dan düşük saptanmıştır. MS hastalarında aksonal yollar boyunca izlenen plakların aksonal yollarda kesintiye neden olduğu gösterilmiştir. Tartışma: Normal görünen beyaz cevherden plak düzeyine doğru anizotropideki progresif artış myelin hasarını göstermektedir. Bu da konvansiyonel MR'da T2 görüntülerde normal görünen beyaz cevherin aslında normal olmadığını düşündürmektedir. Bu sonuçlara dayanarak MS hastalarında hastalık yükünün değerlendirilmesinde Difüzyon tensör görüntülemenin faydalı olacağı düşünülmüştür.

Keywords

• Multiple Sclerosis
• Diffusion Tensor Imaging
• Fractional Anisotropy
• Magnetic Resonance Imaging

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