title: Diffusional kurtosis imaging of normal-appearing white matter in multiple sclerosis: preliminary clinical experience.
abstract: OBJECTIVE
  We evaluated diffusional changes in normal-appearing white matter (NAWM) regions remote from multiple sclerosis (MS) plaques by using diffusional kurtosis imaging (DKI) to investigate the non-Gaussian behavior of water diffusion.
  
  
  METHODS
  Participants were 11 MS patients and 6 age-matched healthy volunteers. DKI was performed on a 3-T MR imager. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and diffusional kurtosis (DK) maps were computed. Regions of interest (ROIs) were compared in 24 cerebral regions, including the frontal, parietal, and temporal lobe white matter (WM) in controls and NAWM in MS patients.
  
  
  RESULTS
  The mean FA of all ROIs was 0.468 ± 0.014 (SD) (controls) or 0.431 ± 0.029 (MS group) (P = 0.016). Mean ADC was 0.785 ± 0.034 × 10(-3) mm(2)/s (controls) or 0.805 ± 0.041 × 10(-3) mm(2)/s (MS group). The mean DK of all ROIs was 0.878 ± 0.020 (controls) or 0.823 ± 0.032 (MS group) (P = 0.002). Analysis of individual ROIs revealed significant differences in DK in 3 ROIs between normal WM and NAWM, but significant differences in ADC and FA in only one ROI each.
  
  
  CONCLUSIONS
  DKI may be a new sensitive indicator for detecting tissue damage in MS patients in addition to conventional diffusional evaluations, for example diffusion tensor imaging.
authors.affiliation: Department of Radiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan. mrk.ysd@gmail.com
authors.forename: Mariko
authors.initials: M
authors.lastname: Yoshida
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hori
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Issa
authors.initials: I
authors.lastname: Fukunaga
authors.forename: Michimasa
authors.initials: M
authors.lastname: Suzuki
authors.forename: Koji
authors.initials: K
authors.lastname: Kamagata
authors.forename: Keigo
authors.initials: K
authors.lastname: Shimoji
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakanishi
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Masutani
authors.forename: Shigeki
authors.initials: S
authors.lastname: Aoki
mesh_terms: D000328:Adult; D000465:Algorithms; D016880:Anisotropy; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009103:Multiple Sclerosis / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D018709:Statistics, Nonparametric