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Evaluation of Normal‐Appearing White Matter in Multiple Sclerosis Using Direct Visualization of Short Transverse Relaxation Time Component (ViSTa) Myelin Water Imaging and Gradient Echo and Spin Echo (GRASE) Myelin Water Imaging
Author(s) -
Choi Joon Yul,
Jeong In Hye,
Oh SeHong,
Oh ChangHyun,
Park Na Young,
Kim Ho Jin,
Lee Jongho
Publication year - 2019
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26278
Subject(s) - multiple sclerosis , white matter , nuclear medicine , myelin , magnetic resonance imaging , nuclear magnetic resonance , population , chemistry , medicine , radiology , central nervous system , physics , psychiatry , environmental health
Background In multiple sclerosis (MS), not only lesions but also normal MRI‐appearing white matter (NAWM) may undergo demyelination. Purpose To demonstrate the detection of NAWM demyelination using direct visualization of short transverse relaxation time component myelin water imaging (ViSTa‐MWI) and to compare the results with those of conventional gradient echo and spin echo (GRASE)‐MWI. Study Type Control/cohort. Population Twenty‐five MS patients and 18 healthy controls (HC). Field Strength/Sequence 3T/ViSTa and GRASE‐MWI. Assessment Using ViSTa and GRASE‐MWI, myelin water fraction (MWF) of NAWM or normal WM was compared between MS (all patients or early‐stage MS patients) and HC. The comparison was performed for a global WM mask and five regional WM masks. Statistical Tests A general linear model was applied for the comparison. A statistical power and a minimum sample size for the significant difference were obtained. Spearman's correlation coefficient was calculated between MWF and clinical measures and between ViSTa‐MWF and GRASE‐MWF for the global WM mask. Results MWFs of ViSTa were significantly lower in the MS patients than those in the HC in all masks ( P < 0.001). GRASE‐MWI results revealed reduced MWFs only in global WM, genu, and optic radiation. ViSTa‐MWI had higher statistical powers than that of GRASE‐MWI (power: ViSTa = 99.2 ± 1.6% and GRASE = 75.5 ± 31.0%; sample size: ViSTa = 18 ± 9 and GRASE = 78 ± 75). In early‐stage MS, MWFs of ViSTa were significantly lower than those of the HC in all masks except for centrum semiovale; however, MWFs of GRASE MWI were significantly lower only in optic radiation. Disease duration was correlated with both MWIs (ViSTa; r = –0.437 and GRASE; r = –0.445). ViSTa and GRASE MWFs were significantly correlated in the HC ( r = 0.664) and MS ( r = 0.768). Data Conclusion ViSTa‐MWI may detect a reduction of MWF in NAWM of MS. Level of Evidence: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1091–1098.