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Objective: To investigate the extent and severity of cervical cord damage usin g diffusion tensor MRI (DT-MRI) and histogram analysis in patients with primary progressive MS (PPMS). Methods: Diffusion-weighted sensitivity-encoded (SENSE ) echoplanar images of the cervical cord and brain dual-echo and diffusion-wei ghted scans were acquired from 24 patients with PPMS and 13 healthy controls. Cord and brain mean diffusivity and fractional anisotropy histograms were produced. An analysis of variance mod el, adjusting for cord volume, was used to compare cord DT-MRI parameters from controls and patients. Results: Compared to healthy controls, PPMS patients had reduced cervical cord cross-sectional area and average cord fractional anisotro py (p= 0.007), and increased cord mean diffusivity (p = 0.024). No correlations were found between DT-MRI metrics of the cord and quantities obtained from conv entional and DT-MRI of the brain. Conclusions: DT-MRI of the cervical cord can quantify the extent of diffuse cord pathology in patients with PPMS. Such cord diffusivity changes in patients with PPMS are likely to reflect irreversible axo nal injury and reactive gliosis and seem to be independent of brain damage.
Objective: To investigate the extent and severity of cervical cord damage usin g diffusion tensor MRI (DT-MRI) and histogram analysis in patients with primary progressive MS (PPMS). Methods: Diffusion-weighted sensitivity-encoded (SENSE) echoplanar images of the An analysis of variance mod el, adjusting for cord volume, was made from 24 cordies with brain dual-echo and diffusion-wei ghted scans were acquired from 24 patients with PPMS and 13 healthy controls. Cord and brain mean diffusivity and fractional anisotropy histograms were produced. used to compare cord DT-MRI parameters from controls and patients. Results: Compared to healthy controls, PPMS patients had reduced cervical cord cross-sectional area and average cord fractional anisotro py (p = 0.007), and increased cord mean diffusivity (p = 0.024). No correlations were found between DT-MRI metrics of the cord and patterns obtained from conv entional and DT-MRI of the brain. Conclusions: DT-MRI of the cervical cord can quantify the ext ent of diffuse cord pathology in patients with PPMS. Such cord diffusivity changes in patients with PPMS are likely to reflect irreversible axo nal injury and reactive gliosis and seem to be independent of brain damage.