Authors: M P Wattjes M Harzheim G G Lutterbey M Bogdanow H H Schild F Träber
Publish Date: 2007/12/20
Volume: 255, Issue: 1, Pages: 56-63
Abstract
To prospectively investigate metabolic changes in the normalappearing white matter NAWM of patients presenting with clinically isolated syndromes CIS suggestive of multiple sclerosis MS and to correlate these changes to conventional MR imaging findings in terms of MR imaging criteriaMultisequence MR imaging of the brain and 1HMR spectroscopy of the parietal NAWM were performed in 31 patients presenting with CIS and in 20 controls using a 3 0 T MR system MR imaging criteria and International Panel criteria were assessed based on imaging clinical and paraclinical results Metabolite ratios and absolute concentrations of Nacetylaspartate tNAA myoinositol Ins choline Cho and total creatine tCr were determined The metabolite concentrations were correlated with the fulfilled MR imaging criteriaIn comparison to the control group the CIS group showed significantly decreased mean tNAA concentrations –8 1 p = 0 012 Significant changes could not be detected regarding Ins tCr and Cho No significant correlations between absolute metabolite concentrations and MR imaging criteria were observed Patients with and without a lesion dissemination in space showed no significant differences of their metabolite concentrationsAs assessed by 1HMRS a significant axonal damage already occurs during the first demyelinating episode in patients with CIS Conventional MR imaging in terms of diagnostic imaging criteria does not significantly reflect NAWM disease activity in terms of metabolic alterations detected by 1HMR spectroscopy
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