Quantitative volumetric analysis of brain magnetic resonance imaging from patients with multiple sclerosis

• Published in: Journal of the neurological sciences Vol. 158; no. 2; pp. 148 - 153
• Main Authors: Filippi, Massimo, Mastronardo, Giovanna, Rocca, Maria A, Pereira, Clodoaldo, Comi, Giancarlo
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier B.V 30.06.1998; Elsevier Science
• Subjects: Adult; Atrophy; Biological and medical sciences; Brain - pathology; Brain atrophy; Disability; Disabled Persons; Female; Humans; Lesion volumes; Magnetic Resonance Imaging; Magnetization-prepared rapid acquisition gradient echo; Male; Medical sciences; Multiple sclerosis; Multiple Sclerosis - diagnosis; Multiple Sclerosis - physiopathology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Disability; Multiple sclerosis; Magnetic resonance imaging; Lesion volumes; Magnetization-prepared rapid acquisition gradient echo; Brain atrophy; Human; Volumetric analysis; Nervous system diseases; Exploration; Psychometrics; Nuclear magnetic resonance imaging; Inflammatory disease; Atrophy; Central nervous system disease; Functional dependence; Medical imagery; Lesion; Technique
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/S0022-510X(98)00110-5

We compared the volumes of the brain as a whole and of different cerebral structures from patients with multiple sclerosis (MS) and normal subjects. In the patients, we also correlated brain volumes with T2 and T1 lesion loads and disability. A magnetization-prepared rapid acquisition gradient echo (MP RAGE) sequence with subsequent reconstruction of axial 1-mm thick slices and a dual-echo sequence were obtained in 15 patients with relapsing-remitting or secondary progressive MS and 15 sex-, age-, height- and weight-matched normal subjects. The brains and the different cerebral structures studied (cerebral hemispheres, cerebellum and brainstem) were segmented manually by a single observer on the 1-mm MP RAGE scans. The hyperintense lesion volumes seen on dual-echo scans and the hypointense lesion volumes seen on the 1-mm MP RAGE scans were measured using a semi-automated segmentation technique based on local thresholding. Compared to the normal volunteers, patients had significantly lower cerebral ( P=0.008), hemispheric ( P=0.01) and brainstem ( P=0.03) volumes. Cerebral atrophy was detected in seven (47%) MS patients. Patients with brainstem signs had significantly lower mean brainstem volume than the others ( P=0.04). No significant correlations were found between the cerebral volumes and the EDSS scores, the hyperintense lesion volumes and the hypointense lesion volumes. We conclude that cerebral atrophy is a relatively frequent finding in MS, but its relationship with physical disability is modest.