Abstract
BackgroundMRI is the method of choice in the diagnosis of MS as well as in monitoring the disease activity. MRI volumetry is used to assess whole or regional brain volume loss which reflects neurodegenerative aspect of the disease and plays an important role in all stages of disease. The aim of this work is to study MRI volumetry in the evaluation of cerebellum and brain stem volume loss in RRMS patients and its correlation with neurological disability score and number of relapses.ResultsVolumes of whole brainstem, medulla, and pons showed a significant decrease in RRMS cases compared to controls (p < 0.05). Brainstem volume had a mean volume of 22.17 and 25.09 cm3 in cases and controls, respectively. However, midbrain volume showed no significant difference between cases and controls (p = 0.134). Volume of left cerebellar cortex showed a significant decrease in RRMS cases compared to controls (p < 0.001). It had mean volumes of 81.64 and 92.14 ml in cases and controls, respectively, at left cerebellar hemisphere, while right cerebellar hemisphere cortex volumes were 80.37 and 91.97 ml in cases and controls, respectively. Cerebellar white matter showed no significant volume decrease in cases and controls.ConclusionVolumetric MR imaging is an important tool for quantifying the MS disease, assesses MS activity, progression, and tissue loss. The degree and the pattern of atrophy on MRI images correlate significantly with the neurological disability score and number of relapses.
Highlights
Magnetic resonance imaging (MRI) is the method of choice in the diagnosis of Multiple sclerosis (MS) as well as in monitoring the disease activity
It was believed that MS associated with loss of white matter (WM) volume, but recent studies have confirmed greater grey matter (GM) volume loss
Patients who converted into clinically definite MS over a period of 3 years develop significant brain volume loss, confirming early brain atrophy can present in some patients [2, 3]
Summary
MRI is the method of choice in the diagnosis of MS as well as in monitoring the disease activity. The aim of this work is to study MRI volumetry in the evaluation of cerebellum and brain stem volume loss in RRMS patients and its correlation with neurological disability score and number of relapses. Multiple sclerosis (MS) is a central nervous system (CNS) chronic demyelinating, inflammatory disease with axonal loss. MS characterized by progressive CNS atrophy and is thought to be a better correlated with permanent disability than T2 lesion load [1]. Patients who converted into clinically definite MS over a period of 3 years develop significant brain volume loss, confirming early brain atrophy can present in some patients [2, 3]. Magnetic resonance imaging (MRI) studies of MS patients clarify that brain atrophy related to demyelination and axonal loss. Demyelination is potentially reversible process whereas axonal loss is not [4, 5]
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