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. 2014 Jan-Feb;24(1):74-8.
doi: 10.1111/j.1552-6569.2011.00648.x. Epub 2012 Feb 3.

HTLV-I-associated myelopathy/tropical spastic paraparesis: semiautomatic quantification of spinal cord atrophy from 3-dimensional MR images

Iordanis E Evangelou  1 , Raya Massoud, Steven Jacobson
Affiliations

HTLV-I-associated myelopathy/tropical spastic paraparesis: semiautomatic quantification of spinal cord atrophy from 3-dimensional MR images

Iordanis E Evangelou et al. J Neuroimaging. 2014 Jan-Feb.

Abstract

Background: Human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a disabling neurological disorder characterized by inflammatory changes in the spinal cord. We used a semiautomatic technique to quantify spinal cord volume from 3-dimensional MR images of patients with HAM/TSP.

Methods: Five patients and 5 matched healthy volunteers (HVs) underwent MRI of the cervical and thoracic spinal cord at 1.5 T. Quantification of the spinal cord volume was obtained from 3-dimensional MR images using a semiautomatic technique based on level sets. An unpaired t-test was used to assess statistical significance.

Results: Significant differences were found between mean spinal cord volume of HVs and HAM/TSP patients. The thoracic spinal cord volume was 14,050 ± 981 mm(3) for HVs and 8,774 ± 2,218 mm(3) for HAM/TSP patients (P = .0079), a reduction of 38%. The cervical spinal cord volume was 9,721 ± 797 mm(3) for HVs and 6,589 ± 897 mm(3) for HAM/TSP patients (P = .0079), a reduction of 32%. These results suggest that atrophy is evident throughout the spinal cord not routinely quantified.

Conclusions: Semiautomatic spinal cord volume quantification is a sensitive technique for quantifying the extent of spinal cord involvement in HAM/TSP.

Keywords: HAM/TSP; HTLV-I; MRI; Spinal cord; atrophy.

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Figures

Fig 1
Fig 1
Sagittal cervical spinal cord MR images of a HAM/TSP patient acquired with TR/TE/TI (A) T1-weighted (725/12), (B) PD (2700/9.0), (C) T2 (2700/112)-weighted and (D) STIR (5000/28/160). TR = repetition time, TE = echo time, TI = inversion time.
Fig 2
Fig 2
Sagittal thoracic spinal cord MR images of a HAM/TSP patient acquired with TR/TE/TI (A) T1-weighted (725/12), (B) PD (2700/9.0), (C) T2 (2700/112)-weighted and (D) STIR (5000/28/160). TR = repetition time, TE = echo time, TI = inversion time.
Fig 3
Fig 3
Cervical spinal cord volume quantification steps. (A) Sagittal 3D IR-FSPGR MR image (TR/TE/TI/FA, 7.8/3.2/450/20°) after surface coil intensity correction, (B) spinal cord boundary, (C) extracted binary mask, (D) 3D triangulated and rendered surface. TR = repetition time, TE = echo time, TI = inversion time, FA = flip angle.
Fig 4
Fig 4
Thoracic spinal cord volume quantification steps. (A) Sagittal 3D IR-FSPGR MR image (TR/TE/TI/FA, 7.8/3.2/450/20°) after surface coil intensity correction, (B) spinal cord boundary, (C) extracted binary mask, (D) 3D triangulated and rendered surface. TR = repetition time, TE = echo time, TI = inversion time, FA = flip angle.
Fig 5
Fig 5
Cervical spinal cord volumes in healthy volunteers (HV), subjects with HTLV-I infection not meeting criteria for definite HAM/TSP (HTLV) and subjects with definite HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).
Fig 6
Fig 6
Thoracic spinal cord volumes in healthy volunteers (HV), subjects with HTLV-I infection not meeting criteria for definite HAM/TSP (HTLV) and subjects with definite HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).
See this image and copyright information in PMC

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