Magnetization Transfer and Diffusion-Weighted Magnetic Resonance Imaging in Multiple Sclerosis and Other White Matter Diseases

  • M. Filippi
  • G. Comi
Part of the Topics in Neuroscience book series (TOPNEURO)


In white matter diseases, conventional magnetic resonance imaging (MRI) has proved to be sensitive for detecting lesions and their changes over time. However, conventional MRI is not able to characterize and quantify the tissue damage within and outside these lesions. Other quantitative MR techniques have the potential to overcome this limitation. Among these techniques, MR spectroscopy (MRS), magnetization transfer imaging (MTI), and diffusion-weighted imaging (DWI) are those which have been most extensively applied to the assessment of white matter diseases. Since the role of MRS in the assessment of white matter diseases is discussed elsewhere in this book, the present review will summarize the major contributions given by MTI and DWI for the understanding of the evolution of white matter diseases, with a special focus on multiple sclerosis (MS). The application of these two quantitative MR techniques to the study of MS is dramatically changing our understanding of how MS causes irreversible deficits and can serve as an useful model to be applied to other white matter diseases.


Fractional Anisotropy Magnetization Transfer Magnetization Transfer Ratio White Matter Disease Magnetization Transfer Imaging 
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  1. 1.
    Filippi M, Grossman RI, Comi G (eds) (1999) Magnetization transfer in multiple sclerosis. Neurology 53: (Suppl. 3)Google Scholar
  2. 2.
    van Waesberghe JH, Kamphorst W, DeGroot CJ et al (1999) Axonal loss in multiple sclerosis lesions: magnetic resonance imaging insights into substrates of disability. Ann Neurol 46: 747–754PubMedCrossRefGoogle Scholar
  3. 3.
    Dousset V, Grossman RI, Ramer KN et al (1992) Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 182: 483–491PubMedGoogle Scholar
  4. 4.
    Lai HM, Davie CA, Gass A et al (1997) Serial magnetization transfer ratios in gadolinium-enhancing lesions in multiple sclerosis. J Neurol 244: 308–311PubMedCrossRefGoogle Scholar
  5. 5.
    Campi A, Filippi M, Comi G et al (1996) Magnetization transfer ratios of contrastenhancing and nonenhancing lesions in multiple sclerosis. Neuroradiology 38: 115–119PubMedCrossRefGoogle Scholar
  6. 6.
    Hiehle JF, Grossman RI, Ramer KN et al (1995) Magnetization transfer effects in MR-detected multiple sclerosis lesions: comparison with gadolinium-enhanced spin-echo images and non-enhanced T1-weighted images. AJNR Am J Neuroradiol 16:69–77PubMedGoogle Scholar
  7. 7.
    Petrella JR, Grossman RI, McGowan JC et al (1996) Multiple sclerosis lesions: relationship between MR enhancement pattern and magnetization transfer effect. AJNR Am J Neuroradiol 17: 1041–1049PubMedGoogle Scholar
  8. 8.
    Filippi M, Yousry TA, Campi A et al (1996) Comparison of triple dose versus standard dose gadolinium-DTPA for detection of MRI enhancing lesions in patients with multiple sclerosis. Neurology 46: 379–384PubMedCrossRefGoogle Scholar
  9. 9.
    Filippi M, Rocca MA, Comi G (1998) Magnetization transfer ratios of multiple sclerosis lesions with variable durations of enhancement. J Neurol Sci 159: 162–165PubMedCrossRefGoogle Scholar
  10. 10.
    Rocca MA, Mastronardo G, Rodegher M et al (1999) Long term changes of MTderived measures from patients with relapsing-remitting and secondary-progressive multiple sclerosis. AJNR Am J Neuroadiol 20: 821–827Google Scholar
  11. 11.
    Filippi M, Rocca MA, Martino G et al (1998) Magnetization transfer changes in the normal appearing white matter precede the appearance of enhancing lesions in patients with multiple sclerosis. Ann Neurol 43: 809–814PubMedCrossRefGoogle Scholar
  12. 12.
    Filippi M, Tortorella C, Bozzali M (1999) Normal-appearing white matter changes in multiple sclerosis: the contribution of magnetic resonance techniques. Mult Scler 5:273–282PubMedGoogle Scholar
  13. 13.
    Gass A, Barker GJ, Kidd D et al (1994) Correlation of magnetization transfer ratio with disability in multiple sclerosis. Ann Neurol 36: 62–67PubMedCrossRefGoogle Scholar
  14. 14.
    van Waesberghe JHTM, van Walderveen MAA, Castelijns JA et al (1998) Patterns of lesion development in multiple sclerosis: longitudinal observations with T1-weighted spin-echo and magnetization MR. AJNR Am J Neuroradiol 19: 675–683PubMedGoogle Scholar
  15. 15.
    Filippi M, Campi A, Dousset V et al (1995) A magnetization transfer imaging study of normal-appearing white matter in multiple sclerosis. Neurology 45: 478–482PubMedCrossRefGoogle Scholar
  16. 16.
    Loevner LA, Grossman RI, Cohen JA et al (1995) Microscopic disease in normalappearing white matter on conventional MR imaging in patients with multiple sclerosis: assessment with magnetization-transfer measurements. Radiology 196: 511–515PubMedGoogle Scholar
  17. 17.
    Filippi M, Rocca MA, Minicucci L et al (1999) Magnetization transfer imaging of patients with definite MS and negative conventional MRI. Neurology 52: 845–848PubMedCrossRefGoogle Scholar
  18. 18.
    van Buchem MA, McGowan JC, Kolson DL et al (1996) Quantitative volumetric magnetization transfer analysis in multiple sclerosis: estimation of macroscopic and microscopic disease burden. Magn Reson Med 36: 632–636PubMedCrossRefGoogle Scholar
  19. 19.
    Filippi M, Iannucci G, Tortorella C et al (1999) Comparison of MS clinical phenotypes using conventional and magnetization transfer MRI. Neurology 52: 588–594PubMedCrossRefGoogle Scholar
  20. 20.
    Rovaris M, Filippi M, Falautano M et al (1998) Relation between MR abnormalities and patterns of cognitive impairment in multiple sclerosis. Neurology 50: 1601–1608PubMedCrossRefGoogle Scholar
  21. 21.
    van Buchem MA, Grossman RI, Armstrong C et al (1998) Correlation of volumetric magnetization transfer imaging with clinical data in MS. Neurology 50: 1609–1617PubMedCrossRefGoogle Scholar
  22. 22.
    Iannucci G, Minicucci L, Rodegher M et al (1999) Correlations between clinical and MRI involvement in multiple sclerosis: assessment using T1, T2 and MT histograms. J Neurol Sci 171: 121–129PubMedCrossRefGoogle Scholar
  23. 23.
    Filippi M, Inglese M, Rovaris M et al (2000) Magnetization transfer imaging to monitor the evolution of MS: a one-year follow up study. Neurology 55: 940–946PubMedCrossRefGoogle Scholar
  24. 24.
    Tortorella C, Viti B, Bozzali M et al (2000) A magnetization transfer histogram study of normal appearing brain tissue in multiple sclerosis. Neurology 54: 186–193PubMedCrossRefGoogle Scholar
  25. 25.
    Filippi M, Tortorella C, Rovaris M et al (2000) Changes in the normal appearing brain tissue and cognitive impairment in multiple sclerosis. J Neurol Neurosurg Psychiatry 68: 157–161PubMedCrossRefGoogle Scholar
  26. 26.
    Iannucci G, Tortorella C, Rovaris M et al (2000) Prognostic value of MR and magnetization transfer imaging findings in patients with clinically isolated syndromes suggestive of multiple sclerosis at presentation. AJNR Am J Neuroradiol 21:1034–1038PubMedGoogle Scholar
  27. 27.
    Bozzali M, Rocca MA, Iannucci G et al (2000) Magnetization transfer histogram analysis of the cervical cord in patients wth multiple sclerosis. AJNR Am J Neuroradiol 20: 1803–1808Google Scholar
  28. 28.
    Filippi M, Bozzali M, Horsfield MA et al (2000) A conventional and magnetization transfer MRI study of the cervical cord in patients with multiple sclerosis. Neurology 54:207–213PubMedCrossRefGoogle Scholar
  29. 29.
    Filippi M, Rocca MA, Moiola L et al (1999) MRI and MTI changes in the brain and cervical cord from patients with Devic’s neuromyelitis optica. Neurology 53: 1705–1710PubMedCrossRefGoogle Scholar
  30. 30.
    Wong KT, Grossman RI, Boorstein JM et al (1995) Magnetization transfer imaging of perivascular hyperintense white matter in the elderly. AJNR Am J Neuroradiol 16:253–258PubMedGoogle Scholar
  31. 31.
    Rocca MA, Colombo B, Pratesi A et al (2000) A magnetization transfer imaging study of the brain in patients with migraine. Neurology 54: 507–509PubMedCrossRefGoogle Scholar
  32. 32.
    Dousset V, Armand JP, Lacoste D et al (1997) Magnetization transfer study of HIV encephalitis and progressive multifocal leukoencephalopathy. AJNR Am J Neuroradiol 18: 859–901Google Scholar
  33. 33.
    Gupta RK, Kathuria KM, Pradhan S (1999) Magnetization transfer MR imaging in CNS tuberculosis. AJNR Am J Neuroradiol 20: 867–875PubMedGoogle Scholar
  34. 34.
    Campi A, Filippi M, Gerevini S et al (1996) Multiple white matter lesions of the brain. Magnetization transfer ratios in systemic lupus erythematosus and multiple sclerosis. Int J Neuroradiol 2: 134–140Google Scholar
  35. 35.
    Rovaris M, Viti B, Ciboddo G et al (1999) Brain involvement in systemic immunemediated diseases: a magnetic resonance and magnetization transfer imaging study. J Neurol Neurosurg Psychiatry 68: 170–177CrossRefGoogle Scholar
  36. 36.
    Tanabe JL, Ezekiel F, Jagust WJ et al (1999) Magnetization transfer ratio of white matter hyperintensities in subcortical ischemic vascular dementia. AJNR Am J Neuroradiol 20: 839–844PubMedGoogle Scholar
  37. 37.
    Kato Y, Matsumura K, Kinosada Y et al (1997) Detection of pyramidal tract lesions in amyotrophic lateral sclerosis with magnetization-transfer measurements. AJNR Am J Neuroradiol 18: 1541–1547PubMedGoogle Scholar
  38. 38.
    Silver NC, Barker GJ, MacManus DG et al (1996) Decreased magnetization transfer ratio due to demyelination: a case of central pontine myelinolysis. J Neurol Neurosurg Psychiatry 61: 208–209PubMedCrossRefGoogle Scholar
  39. 39.
    Iannucci G, Dichgans M, Rovaris M et al (2000) Correlations between clinical findings and MTI metrics of tissue damage in individuals with CADASIL. Stroke (in press)Google Scholar
  40. 40.
    Bagley LJ, Grossman RI, Galetta SL et al (1999) Characterization of white matter lesions in multiple sclerosis and traumatic brain injury as revealed by magnetization transfer contour plots. AJNR Am J Neuroradiol 20: 977–981PubMedGoogle Scholar
  41. 41.
    Ernst T, Chang L, Witt M et al (1999) Progressive multifocal leuko encephalopathy and human immunodeficiency virus-associated white matter lesions in AIDS: magnetization transfer MR imaging. Radiology 210: 539–543PubMedGoogle Scholar
  42. 42.
    Woessner DE (1963) NMR spin-echo self-diffusion measurement on fluids undergoing restricted diffusion. J Phys Chem 67: 1365–1367CrossRefGoogle Scholar
  43. 43.
    Le Bihan D, Turner R, Pekar J, Moonen CTW (1991) Diffusion and perfusion imaging by gradient sensitization: design, strategy and significance. J Magn Reson Imaging 1:7–8PubMedCrossRefGoogle Scholar
  44. 44.
    Basser PJ, Mattiello J, LeBihan D (1994) MR diffusion tensor spectroscopy and imaging. Biophys J 66: 259–267PubMedCrossRefGoogle Scholar
  45. 45.
    Pierpaoli C, Basser PJ (1996) Toward a quantitative assessment of diffusion anisotropy. Magn Reson Med 36: 893–906PubMedCrossRefGoogle Scholar
  46. 46.
    Moseley ME, Kucharczyk J, Monitorovitch J et al (1990) Diffusion-weighted MR imaging of acute stroke: correlation with T2-weighted and magnetic susceptibility enhanced MR imaging in cats. AJNR Am J Neuroradiol 14: 423–429Google Scholar
  47. 47.
    Moseley ME, Cohen Y, Monitorovitch J et al (1990) Early detection of regional cerebral ischemia in cats: comparison of diffusion-and T2-weighted MRI and spectroscopy. Magn Reson Med 14: 330–346PubMedCrossRefGoogle Scholar
  48. 48.
    Warach S, Chien D, Li W et al (1992) Fast magnetic resonance diffusion-weighted imaging of acute human stroke. Neurology 42: 1717–1723PubMedCrossRefGoogle Scholar
  49. 49.
    Lutsep HL, Albers GW, De Crespigni A et al (1997) Clinical utility of diffusion-weighted magnetic resonance imaging in the assessment of ischaemic stroke. Ann Neurol 41:574–580PubMedCrossRefGoogle Scholar
  50. 50.
    Schlaug G, Siewert B, Benfield A et al (1997) Time course of the apparent diffusion coefficient (ADC) abnormality in human stroke. Neurology 49: 113–119PubMedCrossRefGoogle Scholar
  51. 51.
    Minematsu K, Li L, Sotak CH et al (1992) Reversible focal ischemic injury demonstrated by diffusion-weighted magnetic resonance imaging in rats. Stroke 23: 1304–1311PubMedCrossRefGoogle Scholar
  52. 52.
    Heide AC, Richards TL, Alvord EC et al (1993) Diffusion imaging of experimental allergic encephalomyelitis. Magn Reson Med 4: 478–484CrossRefGoogle Scholar
  53. 53.
    Verhoye MR, ’s-Gravenmade EJ, Raman ER et al (1996) In vivo noninvasive determination of abnormal water diffusion in the rat brain studied in an animal model for multiple sclerosis by diffusion-weighted NMR imaging. Magn Reson Imaging 14:521–532PubMedCrossRefGoogle Scholar
  54. 54.
    Larsson HBW, Thomsen C, Frederiksen J et al (1992) In vivo magnetic resonance diffusion measurement in the brain of patients with multiple sclerosis. Magn Reson Imaging 10: 7–12PubMedCrossRefGoogle Scholar
  55. 55.
    Christiansen P, Gideon P, Thomsen C et al (1993) Increased water self-diffusion in chronic plaques and in apparently normal white matter in patients with multiple sclerosis. Acta Neurol Scand 87: 195–199PubMedCrossRefGoogle Scholar
  56. 56.
    Horsfield MA, Lai M, Webb SL et al (1996) Apparent diffusion coefficient in benign and in secondary progressive multiple sclerosis by nuclear magnetic resonance. Magn Reson Med; 36: 393–400PubMedCrossRefGoogle Scholar
  57. 57.
    Droogan AG, Clark CA, Werring DJ et al (1999) Comparison of multiple sclerosis clinical subgroups using navigated spin echo diffusion-weighted imaging. Magn Reson Imaging; 17: 653–661PubMedCrossRefGoogle Scholar
  58. 58.
    Werring DJ, Clark CA, Barker GJ et al (1999) Diffusion tensor imaging of lesions and normal-appearing white matter in multiple sclerosis. Neurology 52: 1626–1632PubMedCrossRefGoogle Scholar
  59. 59.
    Cercignani M, Iannucci G, Rocca MA et al (2000) Pathological damage in MS assessed by diffusion-weighted and magnetization transfer MRI. Neurology 54: 1139–1144PubMedCrossRefGoogle Scholar
  60. 60.
    Filippi M, Iannucci G, Cercignani M et al (2000) A quantitative study of water diffusion in MS lesions and NAWM using echo-planar imaging. Arch Neurol 57:1017–1021PubMedCrossRefGoogle Scholar
  61. 61.
    Filippi M, Cercignani M, Inglese M et al (2000) Diffusion tensor magnetic resonance imaging in multiple sclerosis. Neurology (in press)Google Scholar
  62. 62.
    Cercignani M, Bozzali M, Iannucci G et al (2000) Magnetization transfer ratio and mean diffusivity of normal-appearing white and grey matter from patients with multiple sclerosis. J Neurol Neurosurg Psychiatry (in press)Google Scholar
  63. 63.
    Iwasawa T, Motoba H, Ogi A et al (1997) Diffusion-weighted imaging of the human optic nerve: a new approach to evaluate optic neuritis in multiple sclerosis. Magn Reson Med 38: 484–491PubMedCrossRefGoogle Scholar
  64. 64.
    Jones DK, Lythgoc D, Horsfield MA et al (1999) Characterization of white matter damage in ischaemic leukoaraiosis with diffusion tensor MRI. Stroke 30: 393–397PubMedCrossRefGoogle Scholar
  65. 65.
    Ellis CM, Simmons A, Jones DK et al (1999) Diffusion tensor MRI assesses corticospinal tract damage in ALS. Neurology 53: 1051–1058PubMedCrossRefGoogle Scholar

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© Springer-Verlag Italia 2001

Authors and Affiliations

  • M. Filippi
  • G. Comi

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