Abstract

Background: Optic nerve diffusion imaging is a useful investigational tool of optic nerve microstructure, but is limited by eye-movement-induced optic nerve movement and artifacts from surrounding cerebrospinal fluid, fat, bone and air. Attempts at improving patient cooperation, thus voluntarily limiting eye movement during a standard diffusion imagingsequence, are usually futile. The aim of this study was to establish the impact of optic nerve movement on clinical diffusion parameters of the optic nerve.Method: Twenty-nine healthy volunteers with intact vision and intact conjugate gaze were recruited and subjected to magnetic resonance diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI) of the optic nerves. Twenty right eyes had nerve tracking done using single-shot echo-planar imaging at 20 time points over 3 minutes. Optic nerve movement measurements were correlated with diffusion parameters of apparent diffusion coefficient (ADC), mean diffusivity (MD), fractional anisotropy (FA) and anisotropic index(AI) using Spearman’s rank correlation.Results: No significant correlations were noted between optic nerve movement parameters and ADC in the axial plane and MD of the optic nerve. Low to moderate negative correlations were noted between optic nerve movement parameters and AI and FA and positive correlation with ADC in the radial plane.Conclusion: Optic nerve movement documented during the timespan of standard diffusion sequences (DWI and DTI) has a negative effect on the anisotropic diffusion parameters of the optic nerve. With greater eye movement, optic nerve diffusion appears less anisotropic owing to greater radial diffusion.

Highlights

  • Optic nerve (ON) diffusion imaging has gained prominence as a useful investigational tool for optic nerve microstructure and pathology.[1,2,3] Whilst initially developed to demonstrate the effects of chronic optic neuritis on ON structure, its use in recent studies has revealed early changes in acute optic neuritis, too.[4]

  • A 1.5T Philips Gyroscan was used for magnetic resonance (MR) diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI) of the brain and ONs using the coronal oblique technique for each nerve as previously reported.[7]

  • DTI was obtained in 15 directions and longitudinal, axial and mean diffusivity values were selected for analysis

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Summary

Introduction

Optic nerve (ON) diffusion imaging has gained prominence as a useful investigational tool for optic nerve microstructure and pathology.[1,2,3] Whilst initially developed to demonstrate the effects of chronic optic neuritis on ON structure, its use in recent studies has revealed early changes in acute optic neuritis, too.[4]. The lack of standardisation of imaging parameters has had apparently little effect on the quantitative assessment of ON diffusion parameters Good consistency for such parameters has been determined using the different techniques of Iwasawa’s intravoxel incoherent motion (IVIM),[8] Wheeler-Kingshott’s zonal oblique multislice echo planar imaging (ZOOM EPI),[9] Chabert’s non-Carr-Purcell-Meiboom-Gill fast spin echo (non-CPMG FSE)[10] and our coronal oblique method.[7] Each method, has its own limitation. In most of the ON diffusion techniques, fluid-attenuated inversion recovery (FLAIR) and fat saturation are utilised to minimise the CSF and fat artifact surrounding the nerve, respectively. Optic nerve diffusion imaging is a useful investigational tool of optic nerve microstructure, but is limited by eye-movement-induced optic nerve movement and artifacts from surrounding cerebrospinal fluid, fat, bone and air. The aim of this study was to establish the impact of optic nerve movement on clinical diffusion parameters of the optic nerve

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