Prediction of motor outcome in ischemic stroke involving the pyramidal tract using diffusion tensor imaging

Background and purpose

Early evaluation of the pyramidal tract is a prerequisite in patients with ischemic stroke in order to decide the optimal treatment or to assess appropriate rehabilitation. The aim of this study was to predict motor outcome using quantitative and qualitative diffusion tensor parameters and their correlations with severity of stroke as defined by the National Institutes of Health Stroke Scale (NIHSS).

Materials and methods

Twenty-one patients presenting with ischemic stroke were studied with DTI. All patients had diffusion measurements such as FA values of the affected and unaffected regions and the FA ratio between them. Color FA maps of the pyramidal tract were constructed and the degree of infarctions was classified into groups according to the involvements of the pyramidal tracts. The motor performance of the upper and lower extremities was assessed using the NIHSS on the day of patients’ admission and discharge. The motor outcomes were correlated with the FA values of the pyramidal tract.

Results

The FA values of the affected pyramidal tracts were significantly lower as compared with the unaffected side (p-value <0.01). The reduction in the FA values of the affected side was significantly correlated (r = 0.41 and p-value <0.001) with the degree of pyramidal tract involvements that were significantly correlated with the motor outcome on patients’ discharge day.

Conclusions

Quantitative (FA values) and qualitative (the diffusion tensor tractography) diffusion parameters have potential to predict motor outcome in patients with ischemic stroke.     

Three-tesla diffusion tensor imaging of Meyer's loop by tractography, color-coded fractional anisotropy maps, and eigenvectors

The aim of this study was to evaluate Meyer's loop by 3-T MRI with fiber tractography, color-coded fractional anisotropy maps, and eigenvector maps. The anteroposterior distance from the anterior bundle of the Meyer's loop to temporal pole ranged from 26.3 to 34 mm, overlapping with the previously published anatomical dissection studies. Diffusion tensor imaging with fiber tractography, color-coded FA maps, and color maps of the principal eigenvector at 3 T appear to be promising techniques for the virtual dissection of Meyer's loop.     

Three-dimensional white matter tractography by diffusion tensor imaging in ischaemic stroke involving the corticospinal tract

Diffusion tensor MR imaging (DTI) provides information on diffusion anisotropy, which can be expressed with three-dimensional (3D) white matter tractography. We used 3D white matter tractography to show the corticospinal tract in eight patients with acute or early subacute ischaemic stroke involving the posterior limb of the internal capsule or corona radiata and to assess involvement of the tract. Infarcts and the tract were shown simultaneously, providing information on their spatial relationships. In five of the eight patients, 3D fibre tract maps showed the corticospinal tract in close proximity to the infarct but not to pass through it. All these patients recovered well, with maximum improvement from the lowest score on manual muscle testing (MMT) up to the full score through rehabilitation. In the other three patients the corticospinal tract was shown running through the infarct; reduction in MMT did not necessarily improve favourably or last longer, other than in one patient. As 3D white matter tractography can show spatial relationships between the corticospinal tract and an infarct, it might be helpful in prognosis of gross motor function.     

大脑白质纤维磁共振弥散张量成像扫描参数研究

目的：探讨不同的磁共振弥散张量成像（diffusion tensor imaging,DTI）扫描参数对大脑白质纤维弥散张量图像的影响,以期获得最佳的扫描参数。方法：21例正常志愿者（男11例,女10例;年龄16-63岁,平均38.7岁）参加了该项研究。随机分为3组：b值组、弥散敏感梯度方向组和层厚/层间距组。各组分别应用不同的DTI扫描参数,第1组b值组：可变参数是b值,分别为300、1 000、3 000 s/mm^2mm,不变参数是：层厚/层间距5 mm/0 mm,弥散敏感梯度方向数21。第2组弥散敏感梯度方向组：可变参数是弥散敏感梯度方向数,分别为6、13、21,不变参数是：层厚/层间距5 mm/0 mm,b值为1 000 s/mm^2。第3组层厚/层间距组,可变参数是层厚/层间距,分别为8 mm/2 mm5、mm/0 mm、3.5 mm/0 mm,不变参数是：b值为1 000 s/mm^2,弥散敏感梯度方向数为21。将所成FA图像和DEC图分为3个不同的等级,进行评价。结果：不同的扫描参数所成大脑白质纤维弥散张量图像的质量是不相同的。在b值组,以低b值所成图像较佳,其中以b值=1 000 s/mm^2为最佳,而高b值所成图像噪声较大。施加的弥散敏感梯度方向数并非越多越好,13个方向与21个方向所成图像没有明显差别,6个方向所成图像质量较差。层厚/层间距对图像的影响最大,层厚越厚,图像的信噪比越大。结论：在临床工作中,比较实用的大脑白质纤维弥散张量成像扫描参数为：b值=1 000 s/mm^2,弥散敏感梯度方向数为13,层厚/层间距为5 mm/0 mm。     

Water diffusion anisotropy in white and gray matter of the human spinal cord

PURPOSE: To develop a reliable technique for diffusion imaging of the human spinal cord at 1.5 Tesla and to assess potential differences in diffusion anisotropy in cross-sectional images. MATERIALS AND METHODS: A single-shot echo-planar imaging sequence with double spin-echo diffusion preparation was optimized regarding cerebrospinal fluid artifacts, effective resolution, and contrast-to-noise ratios. Eleven healthy volunteers participated in the study for quantitative characterization of diffusion anisotropy in white matter (WM) and gray matter (GM) by means of two diffusion encoding schemes: octahedral-six-directions for fractional anisotropy (FA) evaluation and orthogonal-three-directions for anisotropy index (AI) calculation. RESULTS: Pulse-trigger gated sequences with optimal matrix size (read x phase = 64 x 32) and b-value (700 s/mm(2)) allowed the acquisition of high-resolved images (voxel size = 0.9 x 0.9 x 5.0 mm(3)). The GM butterfly shape was recognizable in both AI and FA maps. Both encoding schemes yielded high diffusion anisotropy in dorsal WM (FA = 0.79 +/- 0.07; AI = 0.39 +/- 0.04). Lateral WM showed slightly lower anisotropy (FA = 0.69 +/- 0.08; AI = 0.35 +/- 0.03) than dorsal WM. Clearly smaller anisotropy was found in regions containing GM (FA = 0.45 +/- 0.06; AI = 0.21 +/- 0.05). CONCLUSION: Diffusion anisotropy data of the spinal cord can be obtained in a clinical setting. Its application seems promising for the assessment of neurological disorders.     

Comparison of the diagnostic performances of diffusion parameters in diffusion weighted imaging and diffusion tensor imaging of breast lesions

Purpose

To evaluate the diagnostic efficiency of the diffusion parameters measured by conventional diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) for discrimination of malignant breast lesions from benign lesions and the normal breast.

Materials and methods

The study included 52 women with 55 breast lesions (30 malignant, 25 benign). DTI and DWI were performed complementary to dynamic contrast MRI at 3T. Apparent diffusion coefficient (ADC) of DWI, mean diffusivity (MD) and fractional anisotropy (FA) values of DTI were measured for lesions and contralateral breast parenchyma in each patient. We used b factors of 0, 50, 850, 1000 and 1500 s/mm² for DWI and b 0 and 1000 s/mm² for DTI. ADC, MD and FA values were compared between malignant and benign lesions, and the normal parenchyma by univariate and multivariate analyses.

Results

Diffusion parameters showed no difference according to menopausal status in the normal breast. ADC and MD values of the malignant lesions were significantly lower than benign lesions and normal parenchyma (p = 0.001). The FA showed no statistical significance. With the cut-off values of ≤1.23 × 10⁻³ mm²/s (b 0–1000 s/mm²) and ≤1.12 × 10⁻³ mm²/s (b 0–1500 s/mm²), ADC showed 92.85% and 96.15% sensitivity; 72.22% and 73.52% PPV, respectively. With a cut-off value of ≤1.27 × 10⁻³ mm²/s (b 1000 s/mm²), MD was 100% sensitive with a PPV of 65.90%. Comparing the diagnostic performance of the parameters in DTI with DWI, we obtained similar efficiency of ADC with b values of 0,1000 and 0,1500 s/mm² and MD with a b value of 0, 1000 s/mm² (AUC = 0.82 ± 0.07).

Conclusion

ADC of DWI and MD of DTI values provide significant discriminative factors for benign and malignant breast lesions. FA measurement was not discriminative. Supported with clinical and dynamic contrast MRI findings, DWI and DTI findings provide significant contribution to the final radiologic decision.     

Feasibility of 1.6-mm isotropic voxel diffusion tensor tractography in depicting limbic fibers

Introduction We attempted to assess the feasibility of a 1.6-mm isotropic voxel diffusion tensor imaging (DTI) tractography at 3T in visualizing nerve bundles in the limbic system. Methods We examined 20 healthy volunteers by conventional DTI with a voxel size of 1.6 × 1.6 × 3.0 mm and by high-resolution DTI with a voxel size of 1.6 × 1.6 × 1.6 mm and generated tractographs of three limbic nerve bundles: the fornix, cingulum, and uncinate fasciculus. We visually assessed whether these bundles reached their targets and compared their diffusion parameters between the two techniques. Results The entire pathways of the fornix, cingulum, and uncinate fasciculus were more readily visualized by high-resolution DTI than by conventional DTI. Among these, the fimbria of the fornix and the uncinate fasciculus adjacent to the temporal pole were identified more frequently by high-resolution DTI (visualization rate 83 and 100%, respectively) than by conventional DTI (visualization rate 63 and 83%, respectively) at a statistical significance of P < 0.05 and P < 0.01, respectively). Fractional anisotropy values in the fornix, cingulum, and uncinate fasciculus by high-resolution DTI were significantly higher than those by conventional DTI (P < 0.01); in contrast, the apparent diffusion coefficient values of all these fibers except that of the fornix remained unchanged between the two techniques. Conclusion The 1.6-mm istropic voxel DTI at 3T is a feasible visualization tool and can improve the precision of tracking nerve bundles of the limbic system.     

Normal white matter development from infancy to adulthood: comparing diffusion tensor and high b value diffusion weighted MR images

PURPOSE: To evaluate the sensitivity of high b value diffusion weight magnetic resonance imaging (DWI) in detecting normal white matter maturation, compare it to conventional diffusion tensor imaging (DTI), and to obtain normative quantitative data using this method. MATERIALS AND METHODS: High b value DWI (b(max) = 6000 sec/mm(2)) using q-space analysis and conventional DTI (b = 1000 sec/mm(2)) were performed on 36 healthy subjects aged 4 months to 23 years. Fractional-anisotropy (FA), apparent-displacement, and apparent-probability values were measured in all slices and in six regions of interest (ROIs) of large fiber tracks. Values were correlated with each other and with age using regression analysis. RESULTS: FA, displacement, and probability indices from all slices were highly correlated with each other (r > 0.87, P < 0.0001) and with age (r > 0.82, P < 0.0001). All age-related changes in the six pre-determined ROIs were best fitted by mono-exponential functions. Changes in the splenium extended to a later age when compared with the genu of the corpus-callosum, while the centrum semi-ovale demonstrated the latest changes with age. CONCLUSIONS: High b-value DWI and DTI showed changes in white matter from infancy through adulthood. However, high b-value detects a signal that is likely to originate mainly from the intra-axonal water population, and thus may represent different aspects of development and different sensitivity to pathology.     

High angular resolution diffusion imaging reveals intravoxel white matter fiber heterogeneity.

Magnetic resonance (MR) diffusion tensor imaging (DTI) can resolve the white matter fiber orientation within a voxel provided that the fibers are strongly aligned. However, a given voxel may contain a distribution of fiber orientations due to, for example, intravoxel fiber crossing. The present study sought to test whether a geodesic, high b-value diffusion gradient sampling scheme could resolve multiple fiber orientations within a single voxel. In regions of fiber crossing the diffusion signal exhibited multiple local maxima/minima as a function of diffusion gradient orientation, indicating the presence of multiple intravoxel fiber orientations. The multimodality of the observed diffusion signal precluded the standard tensor reconstruction, so instead the diffusion signal was modeled as arising from a discrete mixture of Gaussian diffusion processes in slow exchange, and the underlying mixture of tensors was solved for using a gradient descent scheme. The multitensor reconstruction resolved multiple intravoxel fiber populations corresponding to known fiber anatomy. Ma     

正常成人不同年龄段大脑白质纤维各向异性差异研究

目的:探讨正常成人不同年龄大脑白质纤维磁共振弥散张量各向异性的差异。方法:62名正常志愿者大脑白质纤维不同部位,包括外囊、内囊前肢、内囊后肢、胼胝体膝部和胼胝体压部的FA值和ADC值。结果:胼胝体膝部(F=3.113,P=0.024)和豆状核(F=3.229,P=0.020),在各年龄组之间FA值差异有显著性意义;内囊前肢(F=3.093,P=0.024)和豆状核(F=3.824,P=0.009),ADC值差异有显著性意义。FA值呈正相关的部位有内囊前肢(r=0.293,P=0.0349)、胼胝体膝部(r=0.322,P=0.0202),ADC值呈现正相关的部位只有外囊(r=0.365,P=0.00925)。结论:不同年龄段大脑白质纤维的FA值和ADC值是不同的,随着年龄增大,FA值呈现下降趋势,ADC值则有增高的趋势。     

Usefulness of diffusion tensor imaging of white matter in Alzheimer disease and vascular dementia

Purpose: To evaluate the usefulness of diffusion tensor imaging in detecting the water diffusivity caused by neuropathological change in Alzheimer disease and vascular dementia.

Material and Methods: Twenty patients with Alzheimer disease, 20 with vascular dementia, and 10 control subjects were examined. Diffusion tensor imaging applied diffusion gradient encoding in six non-collinear directions. Fractional anisotropy values were compared in the genu and splenium of the corpus callosum, and anterior and posterior white matter among the three groups.

Results: In the patients with Alzheimer disease, fractional anisotropy values of the posterior white matter were significantly lower than those of controls. In patients with vascular dementia, fractional anisotropy values of the anterior white matter tended to be lower than those of the posterior white matter (P=0.07).

Conclusion: Diffusion tensor imaging reflects the neuropathological changes in the white matter, and may be useful in the diagnosis of Alzheimer disease and vascular dementia.     

Volumetric assessment of tumor infiltration of adjacent white matter based on anatomic MRI and diffusion tensor tractography

RATIONALE AND OBJECTIVES: To perform a retrospective, quantitative assessment of the anatomic relationship between intra-axial, supratentorial, primary brain tumors, and adjacent white matter fiber tracts based on anatomic and diffusion tensor magnetic resonance imaging (MRI). We hypothesized that white matter infiltration may be common among different types of tumor. MATERIAL AND METHODS: Preoperative, anatomic (T1- and T2-weighted), and LINESCAN diffusion tensor MRI were obtained in 12 patients harboring supratentorial gliomas (World Health Organization [WHO] Grades II and III). The two imaging modalities were rigidly registered. The tumors were manually segmented from the T1- and T2-weighted MRI, and their volume calculated. A three-dimensional tractography was performed in each case. A second segmentation and volume measurement was performed on the tumor regions intersecting adjacent white matter fiber tracts. Statistical methods included summary statistics to examine the fraction of tumor volume infiltrating adjacent white matter. RESULTS: There were five patients with low-grade oligodendroglioma (WHO Grade II), one with low-grade mixed oligoastrocytoma (WHO Grade II), one with ganglioglioma, two with low-grade astrocytoma (WHO Grade II), and three with anaplastic astrocytoma (WHO Grade III). We identified white matter tracts infiltrated by tumor in all 12 cases. The median tumor volume (+/- standard deviation) in our patient population was 42.5 +/- 28.9 mL. The median tumor volume (+/- standard deviation) infiltrating white matter fiber tracts was 5.2 +/- 9.9 mL. The median percentage of tumor volume infiltrating white matter fiber tracts was 21.4% +/- 9.7%. CONCLUSIONS: The information provided by diffusion tensor imaging combined with anatomic MRI might be useful for neurosurgical planning and intraoperative guidance. Our results confirm previous reports that extensive white matter infiltration by primary brain tumors is a common occurrence. However, prospective, large population studies are required to definitively clarify this issue, and how infiltration relates to histologic tumor type, tumor size, and location.     

Diffusion tensor magnetic resonance imaging of glial brain tumors

Aim

To evaluate the author's experience with the use of diffusion tensor magnetic resonance imaging (DTI) on patients with glial tumors.

Methods

A retrospective evaluation of a group of 24 patients with glial tumors was performed. There were eight patients with Grade II, eight patients with Grade III and eight patients with Grade IV tumors with a histologically proven diagnosis. All the patients underwent routine imaging including T2 weighted images, multidirectional diffusion weighted imaging (measured in 60 non-collinear directions) and T1 weighted non-enhanced and contrast enhanced images. The imaging sequence and evaluation software were produced by Massachusetts General Hospital Corporation (Boston, MA, USA). Fractional anisotropy (FA) maps were calculated in all patients. The white matter FA changes were assessed within the tumorous tissue, on the tumorous borderline and in the normally appearing white matter adjacent to the tumor. A three-dimensional model of the white matter tract was created to demonstrate the space relationship of the tumor and the capsula interna or corpus callosum in each case using the following fiber tracing parameters: FA step 0.25 and a tensor declination angle of 45 gr. An additional assessment of the tumorous tissue enhancement was performed.

Results

A uniform homogenous structure with sharp demargination of the Grade II tumors and the wide rim of the intermedial FA in all Grade III tumors respectively, were found during the evaluation of the FA maps. In Grade IV tumors a variable demargination was noted on the FA maps. The sensitivity and specificity for the discrimination of low- and high-grade glial tumors using FA maps was revealed to be 81% and 87% respectively. If the evaluation of the contrast enhancement was combined with the evaluation of the FA maps, both sensitivity and specificity were 100%.

Conclusion

Although the evaluation of the fractional anisotropy maps is not sufficient for glioma grading, the combination of the contrast enhancement pattern and fractional anisotropy maps evaluation improves the possibility of distinguishing low- and high-grade glial tumors. Three-dimensional models of the white matter fibers in the corpus callosum and the internal capsule may be used in the presurgical planning.     

DTI和T1WI测值法在早产儿脑发育评估中的应用价值

目的:探讨磁共振扩散张量成像(DTI)和T1WI测值法在早产儿脑发育评估中的应用价值.方法:将32例早产儿根据分娩孕周分为早期早产儿组(出生胎龄≤32周,19例)和中晚期早产儿组(出生胎龄>32周,13例),均进行DTI检查,测量感兴趣区(ROI)的各向异性分数(FA)值和表观扩散系数(ADC)值.ROI包括胼胝体压部...     

DTI对急性脑梗死白质纤维各向异性特征的初步研究

目的:利用磁共振扩散张量成像(DTI)研究健康成人和急性缺血性脑梗死患者大脑白质纤维束各向异性特征。方法:对16例健康志愿者和17例急性脑梗死患者进行T1WI、T2WI、DWI及DTI检查;对DTI数据离线后处理,采用Volume-one 1.64和dTVII-R1软件处理,获得部分各向异性(FA)图及方向编码彩色(DEC)图。对健康志愿者分别在内囊、胼胝体以及半卵圆中心选择兴趣区测量主要白质纤维束的FA值。测量脑梗死患者的梗死区及健侧对应白质区的FA值。结果:FA图和DEC图可显示脑内主要的白质纤维束。正常组不同部位脑白质的FA值不同;大脑半球两侧白质的FA值差异无统计学意义。超急性期脑梗死区白质FA值与对侧相比,可轻度升高或降低;急性期梗死区白质FA值显著低于健侧,差异有统计学意义(t=10.987,P<0.01);急性期梗死区白质FA值下降率与发病时间存在相关关系(相关系数r=0.841,P<0.05)。结论:DTI可显示脑内白质纤维束的走行及分布。FA图及DEC图可以显示梗死区白质纤维束的方向与各向异性的改变程度。急性期脑梗死区FA值下降率随病程延长而增大,该指标可用于反映脑梗死的病程。     

Characterization of white matter alterations in phenylketonuria by magnetic resonance relaxometry and diffusion tensor imaging.

A multimodal MR study including relaxometry, diffusion tensor imaging (DTI), and MR spectroscopy was performed on patients with classical phenylketonuria (PKU) and matched controls, to improve our understanding of white matter (WM) lesions. Relaxometry yields information on myelin loss or malformation and may substantiate results from DTI attributed to myelin changes. Relaxometry was used to determine four brain compartments in normal-appearing brain tissue (NABT) and in lesions: water in myelin bilayers (myelin water, MW), water in gray matter (GM), water in WM, and water with long relaxation times (cerebrospinal fluid [CSF]-like signals). DTI yielded apparent diffusion coefficients (ADCs) and fractional anisotropies. MW and WM content were reduced in NABT and in lesions of PKU patients, while CSF-like signals were significantly increased. ADC values were reduced in PKU lesions, but also in the corpus callosum. Diffusion anisotropy was reduced in lesions because of a stronger decrease in the longitudinal than in the transverse diffusion. WM content and CSF-like components in lesions correlated with anisotropy and ADC. ADC values in lesions and in the corpus callosum correlated negatively with blood and brain phenylalanine (Phe) concentrations. Intramyelinic edema combined with vacuolization is a likely cause of the WM alterations. Correlations between diffusivity and Phe concentrations confirm vulnerability of WM to high Phe concentrations.     

磁共振弥散张量成像对正常大脑白质纤维束构象的初步研究

目的利用磁共振弥散张量成像(DTI)研究正常成人脑内各部位各向异性程度及正常白质纤维束构象特征.方法对25名正常志愿者进行常规MR及DTI序列检查,重建FA图及三维彩色编码张量图.分别在半卵圆中心、基底节区和大脑脚层面测量主要白质束的FA值.结果DTI显示灰质与白质区各向异性存在显著差异,不同部位的白质纤维束各向异性程度亦不相同,且左右两侧基本对称,重建FA图和三维彩色编码张量图可显示白质内大部分主要的白质纤维束.结论DTI可清晰显示脑内白质纤维束的走行及分布,为了解脑功能与白质通路间关系提供了有力研究手段.     

Cerebral white matter degeneration in frontotemporal dementia detected by diffusion-weighted magnetic resonance imaging

RATIONALE AND OBJECTIVE: Brain tissue damage in frontotemporal dementia (FTD) has never been systematically studied using diffusion-weighted imaging (DWI). We studied FTD patients using DWI to determine whether microstructural changes in white matter can be detected in vivo. MATERIALS AND METHODS: Thirteen FTD patients and 15 aged healthy subjects were studied. Mean diffusivity (MD) abnormalities in 28 white matter regions were visually evaluated. In addition, MD values in 10 white matter regions relative to that in the ipsilateral postcentral gyrus were measured. The results were compared between healthy subjects and FTD patients. RESULTS: The visual rating resulted in a significant MD elevation in FTD patients in the bilateral high superior frontal gyri, right orbitofrontal gyrus, bilateral anterior temporal lobes, and left middle temporal lobe (P < .01, respectively). Relative MD comparison revealed a significant MD elevation in FTD patients in the bilateral high superior frontal gyri, bilateral orbitofrontal gyri, and bilateral anterior temporal lobes (P < .05 after Bonferroni correction, respectively). CONCLUSION: Our results demonstrated white matter MD abnormalities in FTD patients. It was suggested that the observed white matter MD abnormalities are secondary to damage in the overlying cortex.     

扩散张量成像在颅内肿瘤周围白质区的应用

目的：评价MR扩散张量成像技术在不同级别胶质瘤、脑膜瘤及转移瘤周围正常脑白质区的应用价值。方法：对43例颅内肿瘤患者行常规MRI及扩散张量成像检查,其中高级别胶质瘤12例,低级别胶质瘤10例,脑膜瘤12例、转移瘤9例。测量瘤周正常脑白质的FA值及对侧相应解剖部位正常脑白质的FA值,行组间统计学分析。结果：高级别胶质瘤瘤周正常脑白质FA值低于对侧正常脑白质FA值,差异有统计学意义（P〈0.05）;低级别胶质瘤、脑膜瘤及转移瘤FA值的差异无统计学意义。高级别胶质瘤瘤周正常脑白质FA值与低级别胶质瘤、脑膜瘤、转移瘤瘤周正常脑白质之间差异有统计学意义,后三者之间的差异比较无统计学意义。结论：MR扩散张量成像技术有助于颅内肿瘤的定性诊断及推测肿瘤细胞的浸润范围。     

Quantitative diffusion tensor deterministic and probabilistic fiber tractography in relapsing-remitting multiple sclerosis

Purpose

Our aim was to study the quantitative fiber tractography variations and patterns in patients with relapsing-remitting multiple sclerosis (RRMS) and to assess the correlation between quantitative fiber tractography and Expanded Disability Status Scale (EDSS).

Material and methods

Twenty-eight patients with RRMS and 28 age-matched healthy volunteers underwent a diffusion tensor MR imaging study. Quantitative deterministic and probabilistic fiber tractography were generated in all subjects. And mean numbers of tracked lines and fiber density were counted. Paired-samples t tests were used to compare tracked lines and fiber density in RRMS patients with those in controls. Bivariate linear regression model was used to determine the relationship between quantitative fiber tractography and EDSS in RRMS.

Results

Both deterministic and probabilistic tractography's tracked lines and fiber density in RRMS patients were less than those in controls (P < .001). Both deterministic and probabilistic tractography's tracked lines and fiber density were found negative correlations with EDSS in RRMS (P < .001). The fiber tract disruptions and reductions in RRMS were directly visualized on fiber tractography.

Conclusion

Changes of white matter tracts can be detected by quantitative diffusion tensor fiber tractography, and correlate with clinical impairment in RRMS.