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Magnetic resonance volumetric techniques in monitoring disease activity in patients with multiple sclerosis
Andělová, Michaela ; Horáková, Dana (advisor) ; Vymazal, Josef (referee) ; Hluštík, Petr (referee)
Clinical course of multiple sclerosis (MS) is heterogenous and white matter lesion count and volume on brain magnetic resonance imaging (MRI) correlate with clinical course only partially. Therefore, there is an urgent need for more reliable prognostic biomarkers. This work explored three imaging markers - spinal cord (SC) imaging (specifically SC volume measurement and assessment of focal and diffuse SC changes), atlas-based model of "disconnectome" (i.e. disruption of brain connectivity due to white matter lesions) and periventricular white matter gradient assessed with T1 relaxometry. For the SC projects, we assessed MRI from 2044 MS patients with a semi-automatic method for SC volume measurement. We confirmed (i) a relationship between diffuse SC changes, SC volume and disability; (ii) a novel finding was that in patients with EDSS ≤ 4.0, diffuse changes contributed to higher disability more than SC volume; (iii) SC volume explains the paradox in patients with dissociation between brain white matter lesion load and disability; (iv) SC focal and/or diffuse changes are present in 75% patients with early MS, of which 43% have diffuse changes that are related to brainstem lesions. In the disconnectome project, we evaluated the disruption of connectivity caused by white mater lesions in 745 patients...
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