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Abstract
ObjectiveThis study aimed to investigate iron deposition and thickness and signal changes in optic radiation (OR) by enhanced T2*-weighted angiography imaging (ESWAN) in patients with relapsing-remitting multiple sclerosis (RRMS) with unilateral and bilateral lesions or no lesions.MethodsFifty-one RRMS patients (42 patients with a disease duration [DD] ≥ 2 years [group Mor], nine patients with a DD < 2 years [group Les]) and 51 healthy controls (group Con) underwent conventional magnetic resonance imaging (MRI) and ESWAN at 3.0 T. The mean phase value (MPV) of the OR was measured on the phase image, and thickness and signal changes of the OR were observed on the magnitude image.ResultsThe average MPVs for the OR were 1,981.55 ± 7.75 in group Mor, 1,998.45 ± 2.01 in group Les, and 2,000.48 ± 5.53 in group Con. In group Mor, 28 patients with bilateral OR lesions showed bilateral OR thinning with a heterogeneous signal, and 14 patients with unilateral OR lesions showed ipsilateral OR thinning with a heterogeneous signal. In the remaining nine patients without OR lesions and in group Con, the bilateral OR had a normal appearance. In the patients, a negative correlation was found between DD and OR thickness and a positive correlation was found between MPV and OR thickness.ConclusionsWe confirmed iron deposition in the OR in the RRMS patients, and the OR thickness was lower in the patients than in the controls.Key Points• Enhanced T2*-weighted magnetic resonance angiography (ESWAN) provides new insights into multiple sclerosis (MS).• Focal destruction of the optic radiation (OR) is detectable by ESWAN.• Iron deposition in OR can be measured on ESWAN phase image in MS patients.• OR thickness was lower in the patients than in the controls.• Iron deposition and thickness changes of the OR are associated with disease duration.
Highlights
Multiple sclerosis (MS) is a multifactorial disease of the central nervous system (CNS) characterised by inflammation, demyelination, neuro-axonal loss, gliosis and diffuse degeneration [1,2,3]
Iron deposition and thickness changes of the optic radiation (OR) are associated with disease duration
We investigated 51 consecutive relapsing-remitting multiple sclerosis (RRMS) patients with visual impairment and without a history of clinical optical neuritis (ON) in both eyes
Summary
Multiple sclerosis (MS) is a multifactorial disease of the central nervous system (CNS) characterised by inflammation, demyelination, neuro-axonal loss, gliosis and diffuse degeneration [1,2,3]. Susceptibility of the visual system to damage in MS makes it an ideal model to study the pathophysiology of MS [7]. The large and highly myelinated axons pass through the periventricular white matter, and are susceptible to focal inflammatory damage in MS [8]. The extent of abnormalities in the OR of MS patients is not fully understood. Many explanations, such as primary OR pathology, subclinical inflammation of the OR, and retrograde degeneration, have been offered, but no convincing evidence has been produced to support any of those hypotheses
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