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Neuroradiology |
1 From the Departments of Radiology (Y.G., R.I.G., J.K.U., L.W., L.J.M.) and Neurology (D.L.K.), Hospital of the University of Pennsylvania, Founders, 3400 Spruce St, Philadelphia, PA 19104-4283; and the Division of Biometrics, School of Public Health, Hahnemann University (M.P.). Received April 19, 1999; revision requested May 5; revision received June 25; accepted August 2. Supported in part by National Institutes of Health grants RO1 NS29029 and NS37172. Address reprint requests to R.I.G. (e-mail: grossman@oasis.rad.upenn.edu).
PURPOSE: To determine annual rates of volumetric changes in the whole-brain parenchyma of patients with relapsing-remitting and secondary progressive multiple sclerosis (MS) and test the hypothesis that these changes correlate with clinical disability.
MATERIALS AND METHODS: A computer-assisted segmentation technique with thin-section magnetic resonance (MR) imaging was used in 36 patients with MS (27 relapsing-remitting, nine secondary progressive) and in 20 control subjects to quantify brain and cerebrospinal fluid volumes. To determine the degree of brain atrophy, the percentage brain parenchyma volume (PBV) relative to that of intracranial contents was calculated.
RESULTS: At the beginning of the study, the PBV was smaller in the MS group than in the control group (P = .007); brain parenchyma volumes were similar. The median rate of brain volume loss was 17.3 mL per year in patients with relapsing-remitting MS and 23.6 mL per year in those with secondary progressive MS. There was a negative correlation between brain atrophy and Expanded Disability Status Scale (EDSS) score in patients with secondary progressive MS (r = -0.69, P = .004) and no correlation in patients with relapsing-remitting MS. T2 lesion volume did not correlate with brain atrophy in either group.
CONCLUSION: The correlation between brain atrophy and EDSS score was better in patients with secondary progressive MS than in those with relapsing-remitting MS.
Index terms: Brain, abnormalities, 13.83, 13.871 • Brain, MR, 13.121411, 13.121416 • Magnetic resonance (MR), volume measurement, 13.121411, 13.12146 • Sclerosis, multiple, 13.871
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