Reduced perfusion in white matter lesions in multiple sclerosis. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: Sowa, Piotr; Bjørnerud, Atle; Nygaard, Gro O.; Damangir, Soheil; Spulber, Gabriela; Celius, Elisabeth G.; Due-Tønnessen, Paulina; Harbo, Hanne F.; Beyer, Mona K.
• Is Part Of: European journal of radiology. Volume 84:Issue 12(2015)
• Page Start: 2605
• Page End: 2612
• Publication Date: 2015-12
• Subjects: AIF arterial input function -- CBF cerebral blood flow -- CBV cerebral blood volume -- DSC dynamic susceptibility contrast -- MRI magnetic resonance imaging -- GM grey matter -- MS multiple sclerosis -- MTT mean transit time -- NAWM normal appearing white matter -- PWI perfusion weighted imaging -- ROI region of interest -- WM white matter -- WML white matter lesions; Dynamic susceptibility contrast -- Perfusion weighted imaging -- Magnetic resonance imaging -- Multiple sclerosis -- Binary mask; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2015.09.007
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: White matter lesions as a whole showed reduced perfusion compared to normal appearing white matter in patient with multiple sclerosis. Analysis with semi-automated and fully automated method for detection of white matter lesions gave similar results. Automatically generated binary masks of brain tissue are a promissing tool for perfusion analysis. ABSTRACT: Objective: To investigate dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) in white matter lesions (WML) in patients with multiple sclerosis (MS), using automatically generated binary masks of brain tissue. Background: WML in MS have in some studies demonstrated perfusion abnormalities compared to normal appearing white matter (NAWM), however perfusion changes in WML in MS have in general not been well documented. Methods: DSC PWI was performed at 1.5 Tesla in 69 newly diagnosed MS patients. Parametric perfusion maps representing cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) were obtained. Binary masks of WML, white matter (WM) and grey matter (GM) were automatically generated and co-registered to the perfusion maps. The WML mask was manually edited and modified to correct for errors in the automatic lesion detection. Perfusion parameters were derived both from WML and NAWM using the manually modified WML mask, and using the original non-modified WML mask (with and without GM exclusion mask). Differences in perfusion measures between WML and NAWM were analyzed. Results: CBF was significantly lower ( p < 0.001) and MTT significantly higher ( p < 0.001) in WML compared to NAWM. CBV did not show significant difference between WML and NAWM. The non-modified WML mask gave similar results as manually modified WML mask if the GM exclusion mask was used in the analysis. Conclusions: DSC PWI revealed lower CBF and higher MTT, consistent with reduced perfusion, in WML compared to NAWM in patients with early MS. Automatically generated binary masks are a promising tool in perfusion analysis of WML.