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Relapsing Neuromyelitis Optica and Relapsing-Remitting Multiple Sclerosis: Differentiation at Diffusion-Tensor MR Imaging of Corpus Callosum¹

¹ From the Departments of Radiology (C.S.Y., K.C.L., W.Q.) and Neurology (Y.X., H.S., P.C.), Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053, People's Republic of China; and State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China (C.Z.Z.). Received May 29, 2006; revision requested August 1; revision received August 14; accepted September 18; final version accepted November 15. Supported in part by the Natural Science Foundation of China (no. 30670601), Beijing Scientific and Technological New Star Program (2005B21), and Beijing Natural Science Foundation (7042026). Address correspondence to K.C.L. (e-mail: kunchengli{at}yahoo.com.cn).

Purpose: To prospectively assess sensitivity and specificity of diffusion indexes of the corpus callosum (CC) for differentiating relapsing neuromyelitis optica (RNMO) from relapsing-remitting multiple sclerosis (RRMS), by using final clinical diagnosis as the reference standard.

Materials and Methods: Participants provided informed consent; the study was approved by the institutional review board. Forty-six consecutive patients with RRMS (18 men, 28 women; mean age, 37.7 years; range, 18–58 years) and 26 consecutive patients with RNMO (two men, 24 women; mean age, 38.6 years; range, 19–59 years) underwent diffusion-tensor magnetic resonance imaging. Mean diffusivity (MD) and fractional anisotropy (FA) of the region of interest (ROI) of the CC in the midsagittal plane were measured and used as discriminative indexes. Bayesian classification with leave-one-out cross-validation was used to determine diagnostic accuracy. Differences in diffusion indexes of ROIs among groups were evaluated by using the Kruskal-Wallis test, followed by the Mann-Whitney U test for multiple comparisons and Bonferroni correction.

Results: Mean MD (8.48 x 10^–4 mm²/sec) and FA (0.729) of the ROI in patients with RNMO were significantly (P < .001) different from those (MD = 10.64 x 10^–4 mm²/sec, FA = 0.599) in patients with RRMS. Sensitivity and specificity for differentiation were 92.3% (24 of 26 patients with RNMO) and 93.5% (43 of 46 patients with RRMS) for FA and 88.5% (23 of 26 patients with RNMO) and 89.1% (41 of 46 patients with RRMS) for MD, respectively.

Conclusion: Measurement of diffusion indexes of the CC may be useful for distinguishing patients with RNMO from those with RRMS.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2441060930/DC1

© RSNA, 2007

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