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Objective To assess the diffusion changes of normal⁃appearing spinal cord (NASC) in patients with multiple sclerosis (MS). Methods Axial diffusion tensor imaging (DTI) of the cervical spinal cord was performed in 13 patients with MS and 13 sex ⁃ and age ⁃ matched healthy controls. Fractional anisotropy (FA) and mean diffusivity (MD) measurements were made in the spinal cord at the C2-5 level. Regions of interest (ROIs) were placed in the anterior, lateral, posterior spinal cord, and the central spinal cord. Expanded Disability Status Scale (EDSS) scores were investigated. Study t ⁃ test and Pearman correlation were performed. Results Compared with healthy controls, FA in NASC of patients with MS was significantly decreased in several regions including the left anterior (mean ± SD of 0.44 ± 0.06 versus 0.48 ± 0.04 in control subjects, P = 0.000), right anterior (0.42 ± 0.06 versus 0.48 ± 0.04, P = 0.000), left lateral (0.48 ± 0.06 versus 0.51 ± 0.01, P = 0.001), right lateral (0.49 ± 0.06 versus 0.51 ± 0.03, P = 0.007), and left posterior (0.48 ± 0.06 versus 0.51 ± 0.03, P = 0.002), right posterior (0.48±0.06 versus 0.50 ± 0.03, P = 0.007). Negative correlation was observed between FA reduction with EDSS scores (r = ⁃ 0.328-⁃ 0.207, P = 0.001-0.035). Positive correlation was seen between MD with EDSS scores in ROIs (r = 0.234-0.409, P = 0.000-0.018). Conclusion NASC diffusion abnormalities were found in patients with MS. The association between FA in NASC and EDSS suggests FA may be a potentially quantitative biomarker for monitoring clinical severity of MS with latent lesion. DOI10.3969/j.issn.1672⁃6731.2012.04.007

Study on diffusion tensor imaging of cervical spinal cord in patients with multiple sclerosis