Quantitation of brain tissue changes associated with white matter hyperintensities by diffusion-weighted and magnetization transfer imaging: the LADIS (Leukoaraiosis and Disability in the Elderly) study.
OBJECTIVE
To explore the value of diffusion-weighted imaging (DWI) and magnetization transfer imaging (MTI) for the improved detection and quantification of cerebral tissue changes associated with ageing and white matter hyperintensities (WMH).


METHODS
DWI (n = 340) and MTI (n = 177) were performed in nine centers of the multinational Leukoaraiosis And DISability (LADIS) study investigating the impact of WMH on 65- to 85-year-old individuals without prior disability. We assessed the apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) of normal appearing brain tissue (NABT) and within WMH and related them to subjects' age and WHM severity according to the Fazekas score.


RESULTS
ADC and MTR values showed a significant inter-site variation, which was stronger for the MTR. After z-transformation multiple regression analysis revealed WMH severity and age as significant predictors of global ADC and MTR changes. Only lesional ADC, but not MTR was related to WMH severity.


CONCLUSIONS
ADC and MTR are both sensitive for age and WMH related changes in NABT. The ADC is more sensitive for tissue changes within WMH and appears to be more robust for multicenter settings.
Ropele
Stefan
S
Department of Neurology, Medical University of Graz, Austria. stefan.ropele@meduni-graz.at
Seewann
Alexandra
A
Gouw
Alida A
AA
van der Flier
Wiesje M
WM
Schmidt
Reinhold
R
Pantoni
Leonardo
L
Inzitari
Domenico
D
Erkinjuntti
Timo
T
Scheltens
Philip
P
Wahlund
Lars O
LO
Waldemar
Gunhild
G
Chabriat
Hugues
H
Ferro
José
J
Hennerici
Michael
M
O'Brien
John
J
Wallin
Anders
A
Langhorne
Peter
P
Visser
Marieke C
MC
Barkhof
Frederik
F
Fazekas
Franz
F
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D049292:Leukoaraiosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012720:Severity of Illness Index