Rate of ventricular enlargement in multiple sclerosis: a nine-year magnetic resonance imaging follow-up study.
BACKGROUND
In multiple sclerosis (MS), brain atrophy assessed by linear measurements of ventricular widths has been reported to be well correlated with three-dimensional (3D) measurements. Therefore, serial linear measurements with no need for advanced 3D evaluation may be proven to be robust markers of irreversible, destructive changes.


OBJECTIVE
To evaluate the rate of supratentorial ventricular enlargement representing four decades of disease span.


METHODS
37 MS patients with disease duration at baseline ranging from 1 to 33 years were included. The mean time of the individual magnetic resonance imaging (MRI) follow-up was 9.25 years (range 7.3-10 years). Enlargement rate of the third and lateral ventricles was studied over time by applying three linear measurements on axial 5-mm T1-weighted MRI images.


RESULTS
Progression of supratentorial ventricular widths during 9 years' follow-up was found. The mean annual width increase of the third ventricle was 0.20 mm (P<0.001, 95% confidence interval [CI] 0.15-0.25), for the frontal horn width 0.32 mm (P<0.001, 95% CI 0.23-0.40), and increase of the intercaudate distance was 0.26 mm (P<0.001, 95% CI 0.19-0.33). The association between these three measurements and disability status persisted at the time of follow-up.


CONCLUSIONS
We found uniform ventricular enlargement progression during four decades of disease span, suggesting unchanging total brain atrophy progression over time.
Division of Radiology, Department of Clinical Science, Intervention, and Technology, Karolinska Institute, Stockholm, Sweden. juha.martola@ki.se
J
J
Martola
L
L
Stawiarz
S
S
Fredrikson
J
J
Hillert
J
J
Bergstrom
O
O
Flodmark
P
P
Aspelin
M
M
Kristoffersen Wiberg
D000328:Adult; D017668:Age of Onset; D000368:Aged; D001284:Atrophy / Q000175:diagnosis; D001927:Brain Diseases / Q000175:diagnosis*; D002552:Cerebral Ventricles / Q000473:pathology*; D015331:Cohort Studies; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D016017:Odds Ratio; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors