title: Magnetization transfer imaging in patients with clinically isolated syndromes suggestive of multiple sclerosis.
abstract: OBJECTIVE
  In patients with multiple sclerosis (MS), reduced magnetization transfer ratios (MTRs) have been reported in white matter that appears normal on studies obtained with conventional imaging techniques. The stage in the disease when this first becomes detectable is unclear. The purpose of this study was to measure the MTR of normal-appearing white matter (NAWM) and lesions in patients with clinically isolated syndromes (CIS), many of whom are at the earliest stages of MS, and to determine the prognostic value of any observed changes.
  
  
  METHODS
  Twenty-seven CIS patients and 13 matched control subjects were studied. The mean MTR was measured from 10 regions of NAWM and, when present, from lesions. The patients were followed-up clinically for a median of 12 months.
  
  
  RESULTS
  There was no significant difference in the mean MTR between NAWM in control subjects (38.5% units) and that in CIS patients (38.4% units). After 12 months' follow-up, MS developed in 26% of the patients. The MTR of NAWM in these patients did not differ from that of the other patients or the control subjects.
  
  
  CONCLUSIONS
  The reduced MTR in NAWM, described in established MS, was not detectable in patients with CIS. MTR did not provide prognostic information for this short period of follow-up.
authors.affiliation: NMR Research Unit, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Brex
authors.forename: S M
authors.initials: SM
authors.lastname: Leary
authors.forename: G T
authors.initials: GT
authors.lastname: Plant
authors.forename: A J
authors.initials: AJ
authors.lastname: Thompson
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D011379:Prognosis; D012016:Reference Values