title: Application of a B-spline active surface technique to the measurement of cervical cord volume in multiple sclerosis from three-dimensional MR images.
abstract: OBJECTIVE
  To evaluate the ability of a B-spline active surface technique to detect cervical spinal cord atrophy due to multiple sclerosis (MS) compared with intensity-based contouring.
  
  
  METHODS
  In a previously reported study, the cervical spinal cords of 28 MS patients and 13 age-matched controls were imaged with a volume-acquired inversion-prepared fast spoiled gradient echo sequence at baseline and after one year. The images were reanalyzed using the B-spline technique and the results compared with the results obtained in the original report using intensity-based contouring.
  
  
  RESULTS
  The mean cervical spinal cord volume determined by the active surface programme was 6487 mm(3) in 28 patients compared with 7117 mm(3) in controls (P = 0.002, corrected for age and gender). The patients' cervical spinal cord volumes were associated with expanded disability status scale scores (parameter estimate = -1.21 x 10(-3), r(2) = 0.39, P = 0.001). The patients' cervical spinal cord volumes did not decrease significantly over one year, unlike the mean cervical spinal cord areas at C2/3 calculated using intensity-based contouring.
  
  
  CONCLUSIONS
  The active surface technique can detect cervical spinal cord atrophy due to MS, which has functional significance. However, this methodology is less sensitive at detecting small serial changes compared with the previously reported method.
authors.affiliation: NMR Research Unit, Institute of Neurology, University College London, London, UK.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Hickman
authors.forename: Olivier
authors.initials: O
authors.lastname: Coulon
authors.forename: Geoffrey J M
authors.initials: GJ
authors.lastname: Parker
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Barker
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Stevenson
authors.forename: Declan T
authors.initials: DT
authors.lastname: Chard
authors.forename: Simon R
authors.initials: SR
authors.lastname: Arridge
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thompson
authors.forename: David H
authors.initials: DH
authors.lastname: Miller
mesh_terms: D001284:Atrophy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D009333:Neck; D013116:Spinal Cord / Q000473:pathology*