Diffusion tensor imaging and three-dimensional brain fiber tracking for the diagnosis of multiple sclerosis

Objective: To demonstrate the diffusion tensor imaging (DTI) characteristics of multiple sclerosis (MS) plaques, periplaque white matter regions and normal appearing white matter (NAWM) regions in patients with MS, and to evaluate the clinical values of DTI and three-dimensional brain fiber tracking for the diagnosis of MS. Methods: Conventional MRI and DTI were performed in 32 patients with MS and 32 age-matched control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps were generated and coregistered with T₂-weighted MR images. FA and ADC values were calculated in regions of interest in plaques, periplaque white matter regions, NAWM regions and white matter regions in control subjects. And three-dimensional brain fiber tracking maps were generated by using the DTI. Results: The ADC was (1.233 ± 0.119) x 10^-3 mm²/s in MS plaques, (0.973 ± 0.098) x 10^-3 mm²/s in periplaque white matter regions, (0.748 ± 0.089) x 10^-3 mm²/s in NAWM, and (0.620 ± 0.094) x 10^-3 mm²/s in control subjects. The FA was 0.225 ± 0.052 in MS plaques, 0.311 ± 0.050 in periplaque white matter regions, 0.421 ± 0.070 in NAWM, and 0.476 ± 0.069 in control subjects. Significant differences in FA and ADC values were observed among all white matter regions (P<0.01). MS plaques were demonstrated in three-dimensional brain fiber tracking maps. Conclusion: FA and ADC maps are helpful for the evaluation of all white matter changes of MS. The abnormalities of white matter fiber tracts in MS plaques could be demonstrated in three-dimensional brain fiber tracking maps. (authors)