Magnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis

Objective-To assess the feasibility of a new technique based on diffusion a nisotropy to segment white and grey matter of the brain. To use this techni que to measure the mean diffusivity ((D) over bar) and magnetisation transf er ratio (MTR) of normal appearing white matter (NAWM) and grey matter (NAG M) from patients with multiple sclerosis. Methods-Dual echo turbo spin echo, MT, and diffusion weighted scans of the brain were obtained from 30 patients with multiple sclerosis and 18 sex and age matched healthy controls. After image coregistration and removal of T2 visible lesions, white and grey matter were segmented from 10 supratentori al slices using diffusion anisotropy thresholds. Histograms of the average MTR and (D) over bar were created for normal white and grey matter of contr ols and NAWM and NAGM of patients with multiple sclerosis. Results-All the MTR histogram derived metrics of the NAWM from patients wit h multiple sclerosis were significantly lower than those of white matter fr om controls. The peak height of the D histogram of NAWM from patients with multiple sclerosis was also significantly different from that of normal whi te matter. The average MTR, the peak location of the MTR histogram, and pea k height of the (D) over bar histogram of the NAGM of patients with multipl e sclerosis were significantly lower than the corresponding quantities of g rey matter from controls. Conclusions-A technique was developed for segmenting white and grey matter with the potential for improving the understanding of the pathophysiology o f many neurological conditions. Its application to the study of multiple sc lerosis confirms the presence of a diffuse tissue damage in the NAWM of the se patients and suggests that subtle changes also occur in the NAGM.