1H-Magnetic Resonance Spectroscopy in diffuse and focal cervical cord lesions in Multiple Sclerosis

Bellenberg, Barbara; Busch, Martin; Trampe, Nadine; Gold, Ralf; Chan, Andrew; Lukas, Carsten
December 2013
European Radiology;Dec2013, Vol. 23 Issue 12, p3379
Academic Journal
Objectives: To investigate differences between focal and diffuse cervical lesions in multiple sclerosis (MS) by proton magnetic resonance spectroscopy ( 1H-MRS) at 1.5 T in comparison to quantitative MR imaging of the upper cervical cord area and T2 relaxometry at baseline and follow-up. Methods: Including 22 MS patients with persistent spinal cord symptoms by either diffuse or focal lesions and 17 controls, we acquired MRS, the mean cord area and the water T2 relaxation time and disability at baseline and follow-up. Cross-sectional analyses included group-level comparisons and correlation studies. Follow-up studies covered assessment of reproducibility and progression of the baseline results. Results: Compared with focal lesions, diffuse lesions were attended by more cord atrophy, longer T2, elevated levels of creatine (Cre) and reduced N-acetyl aspartate (NAA)/Cre (focal/diffuse: 83 ± 9/73 ± 15 mm 2, 121 ± 21/104 ± 13 ms, 3.6 ± 1.1/5.1 ± 2.4 mM, 2.4 ± 1.1/2.0 ± 0.9). NAA/Cre at baseline was associated significantly with cord atrophy and with clinical progression during follow-up. Baseline MRS results were not significantly correlated to the clinical disability parameters. The reproducibility of MRS was 0.17-0.30. Longitudinal changes of the MRS results were not statistically significant. Conclusions: MRS indicated differences in demyelination and gliosis between diffuse and focal cervical lesions in MS. Although longitudinal spectral and clinical changes were sparse, NAA/Cre turned out to be the most sensitive spectral parameter. Key Points: • MR spectroscopy shows differences between focal and diffuse spinal cord MS lesions.• MRS indicates axonal degeneration and gliosis in MS compared with controls.• MRS results are associated with cervical cord atrophy.• MRS may help clinicians to monitor spinal cord damage in MS.


Related Articles

  • Imaging of ependymomas: MRI and CT. Yuh, E. L.; Barkovich, A. J.; Gupta, N. // Child's Nervous System;Oct2009, Vol. 25 Issue 10, p1203 

    The imaging features of intracranial and spinal ependymoma are reviewed with an emphasis on conventional magnetic resonance imaging (MRI), perfusion MRI and proton magnetic resonance spectroscopy, and computed tomography. Imaging manifestations of leptomeningeal dissemination of disease are...

  • Spinal cord grey matter abnormalities are associated with secondary progression and physical disability in multiple sclerosis. Kearney, H.; Schneider, T.; Yiannakas, M. C.; Altmann, D. R.; Wheeler-Kingshott, C. A. M.; Ciccarelli, O.; Miller, D. H. // Journal of Neurology, Neurosurgery & Psychiatry;Jun2015, Vol. 86 Issue 6, p608 

    Background: In multiple sclerosis (MS), pathological studies have identified substantial demyelination and neuronal loss in the spinal cord grey matter (GM). However, there has been limited in vivo investigation of cord GM abnormalities and their possible functional effects using MRI combined...

  • Cognition in multiple sclerosis: relevance of lesions, brain atrophy and proton MR spectroscopy. Giorgio, Antonio; Stefano, Nicola // Neurological Sciences;Nov2010, Vol. 31, p245 

    The overall burden of brain MRI-visible lesions does not fully account for cognitive impairment in multiple sclerosis (MS). Several MRI studies have highlighted the importance of brain damage in the normal-appearing brain tissue. Brain atrophy (global, cortical, white and deep grey matter) is...

  • EPIDEMIOLOGICAL AND CLINICAL FEATURES OF PATIENTS WITH DISSEMINATED SCLEROSIS IN PERM REGION. Zhelnin, A. V. // Saratov Journal of Medical Scientific Research / Saratovskii Nau;Jan-Mar2013, Vol. 9 Issue 1, p69 

    The purpose of the article is to identify the epidemiological and clinical features of disseminated sclerosis (DS) in Perm region. Material and methods: Data have been analyzed in 932 patients with DS. Among them there were 607 women (65%) and 325 men (35%). The age of patients with DS varied...

  • Metachromatic Leukodystrophy. Sener, R. N. // Acta Radiologica;Jul2003, Vol. 44 Issue 4, p440 

    Abstract Metachromatic leukodystrophy is characterized by dysmyelination caused by a deficiency of arylsulfatase-A. In a 17-month-old boy with metachromatic leukodystrophy, an echo-planar diffusion MR sequence revealed a restricted diffusion pattern in the deep white matter, manifested by...

  • Comparison of conventional and diffusion-weighted MRI and proton MR spectroscopy in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like events. K. Abe; H. Yoshimura; H. Tanaka; N. Fujita; T. Hikita; S. Sakoda // Neuroradiology;Feb2004, Vol. 46 Issue 2, p113 

    The mechanism of neurological disturbances in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is controversial. We studied 12 patients with MELAS using conventional and diffusion weighted MRI (DWI) and MR spectroscopy (MRS), to look at the...

  • Poster Abstract #15: MRI Measurement of Whole Spinal Cord Volume at 3T: Reproducibility and Relevance to Multiple Sclerosis Arora, Ashish; Neema, Mohit; Stankiewicz, James; Guss, Jason G.; Bakshi, Rohit // Neurotherapeutics;Jul2008, Vol. 5 Issue 3, p495 

    Objective: Determine the reproducibility and clinical relevance of measuring whole spinal cord volume in healthy controls and patients with multiple sclerosis (MS) using 3T MRI. Background: Spinal cord atrophy may be especially relevant to disability in MS. The advent of 3T MRI brings the...

  • MRI characteristics in 48 patients with Brachial Monomelic Amyotrophy. Nalini, A.; Goel, Gaurav; Ravishankar, S. // Annals of Indian Academy of Neurology;Nov2008 Supplement, Vol. 11, pS178 

    Objective: To investigate various magnetic resonance (MR) imaging findings in the Brachial Monomelic Amyotrpohy (BMMA). Materials and Methods: MR images of 48 patients with classical BMMA were evaluated for localized cord atrophy, asymmetric cord flattening, abnormal cervical curvature,...

  • Hirayama Disease: Escaping From the Quotidian Imaging. AGARWAL, ARJIT; CHANDAK, SHRUTI; JOON, PAWAN // Journal of Clinical & Diagnostic Research;Aug2015, Vol. 9 Issue 8, p10 

    Hirayama disease is a rare type of neurological disease commonly manifesting as brachial monomelic amyotrophy in young males of Asian origin, easily understood as juvenile non-progressive cervical amyotrophy. The first case was reported by Hirayama in 1959. The pathogenesis is attributed towards...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics