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Role of thalamic diffusion for disease differentiation between multiple sclerosis and ischemic cerebral small vessel disease

  • Diagnostic Neuroradiology
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Abstract

Introduction

Cerebral small vessel disease (CSVD) and multiple sclerosis (MS) both harbor multiple, T2-hyperintense white matter lesions on conventional magnetic resonance imaging (MRI).We aimed to determine the microstructural changes via diffusion-weighted imaging (DWI) in normal appearing thalami. We hypothesized that the apparent diffusion coefficient (ADC) values would be different in CSVD and MS, since the extent of arterial involvement is different in these two diseases.

Methods

DWI was performed for 50 patients with CSVD and 35 patients with MS along with gender- and age-matched controls whose conventional MRI revealed normal findings. DWI was done with 1.5 Tesla MR devices using echo planar imaging (EPI) for b = 0, 1000 s/mm2. ADC values were obtained from the thalami which appeared normal on T2-weighted and FLAIR images. Standard oval regions of interest (ROIs) of 0.5 cm2 which were oriented parallel to the long axis of the thalamus were used for this purpose.

Results

The mean ADC value of the thalamus was (0.99 ± 0.16) × 10−3 mm2/s in patients with CSVD, whereas the mean ADC value was (0.78 ± 0.06) × 10−3 mm2/s in the control group. The mean ADC value was significantly higher in patients with CSVD compared to the controls (p < 0.001). The mean ADC values of the thalamus were (0.78 ± 0.08) × 10−3 mm2/s in MS patients, and (0.75 ± 0.08) × 10−3 mm2/s in the control group, which are not significantly different (p > 0.05).

Conclusion

Our study revealed a difference in the diffusion of the thalami between CSVD and MS. DWI may aid in the radiological disease differentiation.

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Abbreviations

MS:

Multiple sclerosis

CSVD:

Cerebral small vessel disease

MRI:

Magnetic resonance imaging

DWI:

Diffusion-weighted imaging

ADC:

Apparent diffusion coefficient

ROI:

Region of interest

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Ethics Committee of Cumhuriyet University School of Medicine (No. 2007-4/8; decided May 1, 2007) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey

    Bilge Öztoprak, İbrahim Öztoprak & İsmail Şalk

  2. Department of Neurology, Bayındır Hospital, Ankara, Turkey

    Kamil Topalkara

  3. Department of Radiology, Bozok University School of Medicine, Yozgat, Turkey

    Mustafa F. Erkoç

Authors
  1. Bilge Öztoprak
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  2. İbrahim Öztoprak
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  3. Kamil Topalkara
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  4. Mustafa F. Erkoç
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  5. İsmail Şalk
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Correspondence to Bilge Öztoprak.

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Öztoprak, B., Öztoprak, İ., Topalkara, K. et al. Role of thalamic diffusion for disease differentiation between multiple sclerosis and ischemic cerebral small vessel disease. Neuroradiology 57, 339–347 (2015). https://doi.org/10.1007/s00234-014-1479-z

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  • DOI: https://doi.org/10.1007/s00234-014-1479-z

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