Application of diffusional kurtosis imaging to detect occult brain damage in multiple sclerosis and neuromyelitis optica.
Multiple sclerosis (MS) and neuromyelitis optica (NMO) are two common types of inflammatory demyelinating disease of the central nervous system. Early distinction of NMO from MS is crucial but quite challenging. In this study, 13 NMO spectrum disorder patients (Expanded Disability Status Scale (EDSS) of 3.0 ± 1.7, ranging from 2 to 6.5; disease duration of 5.3 ± 4.7 years), 17 relapsing-remitting MS patients (EDSS of 2.6 ± 1.4, ranging from 1 to 5.5; disease duration of 7.9 ± 7.8 years) and 18 healthy volunteers were recruited. Diffusional kurtosis imaging was employed to discriminate NMO and MS patients at the early or stable stage from each other, and from healthy volunteers. The presence of alterations in diffusion and diffusional kurtosis metrics in normal-appearing white matter (NAWM) and diffusely increased mean diffusivity (MD) in the cortical normal-appearing gray matter (NAGM) favors the diagnosis of MS rather than NMO. Meanwhile, normal diffusivities and kurtosis metrics in all NAWM as well as increases in MD in the frontal and temporal NAGM suggest NMO. Our results suggest that diffusion and diffusional kurtosis metrics may well aid in discriminating the two diseases.
Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong.
Wenshu
W
Qian
Department of Medicine, The University of Hong Kong, Hong Kong. koonho@hku.hk.
Koon Ho
KH
Chan
Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong.
Edward S
ES
Hui
Department of Medicine, The University of Hong Kong, Hong Kong.
Chi Yan
CY
Lee
Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong.
Yong
Y
Hu
Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong. makkf@hku.hk.
Henry Ka-Fung
HK
Mak
D000328:Adult; D000368:Aged; D000465:Algorithms; D058070:Asymptomatic Diseases; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D003937:Diagnosis, Differential; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D009471:Neuromyelitis Optica / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
diffusional kurtosis imaging; multiple sclerosis; neuromyelitis optica; normal-appearing brain tissues