scholarly journals Multicenter Validation of Mean Upper Cervical Cord Area Measurements from Head 3D T1-Weighted MR Imaging in Patients with Multiple Sclerosis

2015 ◽  
Vol 37 (4) ◽  
pp. 749-754 ◽  
Author(s):  
Y. Liu ◽  
C. Lukas ◽  
M.D. Steenwijk ◽  
M. Daams ◽  
A. Versteeg ◽  
...  
Radiology ◽  
2018 ◽  
Vol 288 (1) ◽  
pp. 234-244 ◽  
Author(s):  
Paola Valsasina ◽  
Mohammed Aboulwafa ◽  
Paolo Preziosa ◽  
Roberta Messina ◽  
Andrea Falini ◽  
...  

2014 ◽  
Vol 21 (7) ◽  
pp. 875-884 ◽  
Author(s):  
Viola Biberacher ◽  
Christine C Boucard ◽  
Paul Schmidt ◽  
Christina Engl ◽  
Dorothea Buck ◽  
...  

Background: Despite agreement about spinal cord atrophy in progressive forms of multiple sclerosis (MS), data on clinically isolated syndrome (CIS) and relapsing–remitting MS (RRMS) are conflicting. Objective: To determine the onset of spinal cord atrophy in the disease course of MS. Methods: Structural brain magnetic resonance imaging (MRI) was acquired from 267 patients with CIS (85) or RRMS (182) and 64 healthy controls (HCs). The upper cervical cord cross-sectional area (UCCA) was determined at the level of C2/C3 by a segmentation tool and adjusted for focal MS lesions. The coefficient of variation (CV) was calculated from all measurements between C2/C3 and 13 mm above as a measure of structural variability. Results: Compared to HCs (76.1±6.9 mm2), UCCA was significantly reduced in CIS patients (73.5±5.8 mm2, p=0.018) and RRMS patients (72.4±7.0 mm2, p<0.001). Structural variability was higher in patients than in HCs, particularly but not exclusively in case of focal lesions (mean CV HCs/patients without/with lesions: 2.13%/2.55%/3.32%, all p-values<0.007). UCCA and CV correlated with Expanded Disability Status Scale (EDSS) scores ( r =−0.131/0.192, p=0.044/<0.001) and disease duration ( r=−0.134/0.300, p=0.039/< 0.001). CV additionally correlated with hand and arm function ( r=0.180, p=0.014). Conclusion: In MS, cervical cord atrophy already occurs in CIS. In early stages, structural variability may be a more meaningful marker of spinal cord pathology than atrophy.


2020 ◽  
Vol 41 (11) ◽  
pp. 2062-2067
Author(s):  
R.E. Gabr ◽  
J.A. Lincoln ◽  
A. Kamali ◽  
O. Arevalo ◽  
X. Zhang ◽  
...  

Author(s):  
Claudia E. Weber ◽  
Julia Krämer ◽  
Matthias Wittayer ◽  
Johannes Gregori ◽  
Sigurd Randoll ◽  
...  

Abstract Objectives In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume. Methods Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated. Results Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions. Conclusions Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses. Key Points • Multiple sclerosis patients with iron rim lesions had higher EDSS scores, higher brain and spinal cord lesion loads, lower cortical grey matter volumes, and a lower normalised cross-sectional area of the upper cervical spinal cord. • Iron rim lesions are a new lesion descriptor obtained from susceptibility-weighted MRI. Our data suggests that further exploration of this lesion characteristic in regard to a poorer prognosis in multiple sclerosis patients is warranted.


2013 ◽  
Vol 20 (1) ◽  
pp. 81-90 ◽  
Author(s):  
Luca Prosperini ◽  
Nikolaos Petsas ◽  
Eytan Raz ◽  
Emilia Sbardella ◽  
Francesca Tona ◽  
...  

Objective: To evaluate whether balance deficit in patients with multiple sclerosis (MS), as assessed with eyes opened (EO) and closed (EC), is associated with damage of different structures of the central nervous system (CNS). Methods: Fifty patients with MS and 20 healthy controls (HCs) underwent static posturography to calculate the body’s center of pressure displacement (COP path) with EO and EC. They were scanned using a 3.0T magnet to obtain PD/T2 and 3D-T1-weighted images of the brain and spinal cord. We determined the mid-sagittal cerebellum area (MSCA) and upper cervical cord cross-sectional area (UCCA). We also measured the patients’ lesion volumes (T2-LVs) on the whole brain and at different infratentorial levels. Results: MS patients had wider COP paths with both EO and EC ( p < 0.001), and lower values in both MSCA ( p = 0.01) and UCCA ( p = 0.008) than HCs. The COP path with EO was associated with MSCA (Beta = − 0.58; p = 0.004) and T2-LV on middle cerebellar peduncles (Beta = 0.59; p = 0.002). The COP path with EC was associated with UCCA (Beta= − 22.74; p = 0.003) and brainstem T2-LV (Beta = 0.52; p = 0.01). Conclusions: Balance deficit in MS was related to atrophy of both the cerebellum and spinal cord, but the extent of COP path under the two different conditions (EO or EC) implied different patterns of damage in the CNS.


2014 ◽  
Vol 20 (14) ◽  
pp. 1860-1865 ◽  
Author(s):  
Marita Daams ◽  
Florian Weiler ◽  
Martijn D Steenwijk ◽  
Horst K Hahn ◽  
Jeroen JG Geurts ◽  
...  

Background: The majority of patients with multiple sclerosis (MS) present with spinal cord pathology. Spinal cord atrophy is thought to be a marker of disease severity, but in long-disease duration its relation to brain pathology and clinical disability is largely unknown. Objective: Our aim was to investigate mean upper cervical cord area (MUCCA) in patients with long-standing MS and assess its relation to brain magnetic resonance imaging (MRI) measures and clinical disability. Methods: MUCCA was measured in 196 MS patients and 55 healthy controls using 3DT1-weighted cervical images obtained at 3T MRI. Clinical disability was measured using the Expanded Disability Status Scale (EDSS), Nine-Hole-Peg test (9-HPT), and 25 feet Timed Walk Test (TWT). Stepwise linear regression was performed to assess the association between MUCCA and MRI measures, and between MUCCA and clinical disability. Results: MUCCA was smaller (mean 11.7%) in MS patients compared with healthy controls (72.56±9.82 and 82.24±7.80 mm2 respectively; p<0.001), most prominently in male patients. MUCCA was associated with normalized brain volume, and number of cervical cord lesions. MUCCA was independently associated with EDSS, TWT, and 9-HPT. Conclusion: MUCCA was reduced in MS patients compared with healthy controls. It provides a relevant marker for clinical disability in long-standing disease, independent of other MRI measures.


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