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. 2019 Feb 4:15:233-240.
doi: 10.2147/TCRM.S189598. eCollection 2019.

The features of cerebral permeability and perfusion detected by dynamic contrast-enhanced magnetic resonance imaging with Patlak model in relapsing-remitting multiple sclerosis

Hua Xiong  1   2 , Ping Yin  3 , Xiaojiao Li  1   2 , Chao Yang  1   2 , Dan Zhang  1   2 , Xianlong Huang  1   2 , Zhuoyue Tang  1   2
Affiliations

The features of cerebral permeability and perfusion detected by dynamic contrast-enhanced magnetic resonance imaging with Patlak model in relapsing-remitting multiple sclerosis

Hua Xiong et al. Ther Clin Risk Manag. .

Abstract

Objective: To investigate the features of cerebral permeability and perfusion detected by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with Patlak model in relapsing-remitting multiple sclerosis (RRMS) and their correlations with Expanded Disability Status Scale (EDSS) scores and disease duration.

Patients and methods: Twenty-seven RRMS patients underwent conventional MRI and DCE-MRI with 3.0 T magnetic resonance scanner were enrolled in the study. A Patlak model was used to quantitatively measure MRI biomarkers, including volume transfer constant (Ktrans), fractional plasma volume (Vp), cerebral blood flow (CBF), and cerebral blood volume (CBV). The correlations of MRI biomarkers with EDSS scores and disease duration were analyzed.

Results: The MRI biomarkers Ktrans, Vp, CBF, and CBV of contrast-enhancing (CE) lesions were significantly higher (P<0.05) than those of non-enhancing (NE) lesions and normal-appearing white matter (NAWM) regions. The skewness and kurtosis of Ktrans values in CE lesions were significantly higher (P<0.05) than that of NE lesions. No significant correlation was found among the biomarkers with EDSS scores and disease duration (P>0.05).

Conclusion: Our study demonstrated the abnormalities of permeability and perfusion characteristics in multiple sclerosis (MS) lesions and NAWM regions by DCE-MRI with Patlak model. The Ktrans, Vp, CBF, and CBV of CE lesions were significantly higher than that of NE lesions, but these MRI biomarkers did not associate with the severity and duration of the disease. The skewness and kurtosis of Ktrans value in CE lesions were significantly higher than that in NE lesions, indicating that these parameters of Ktrans histogram can be used to distinguish the pathology of MS lesions.

Keywords: Patlak model; dynamic contrast-enhanced magnetic resonance imaging; histogram; multiple sclerosis; perfusion; permeability.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The time-concentration curves (left) and schematic diagram of the Patlak model (right). Abbreviations: Ktrans, volume transfer constant; Vp, fractional plasma volume.
Figure 2
Figure 2
The representative images of dynamic contrast-enhanced magnetic resonance imaging with Patlak model. Notes: A 24-year-old patient with RRMS. (A) Precontrast T1-weighted: round low signal in the left periventricular areas (arrow). (B) Dynamic contrast-enhanced T1-weighted images: the lesion was enhanced in T1-weighted contrast-enhanced sequences (arrow). (C) Ktrans map. (D) Vp map. (E) CBF map. (F) CBV map. ROI 1 located in CE lesions (Circle 1), ROI 2 located in the NAWM regions close to the lesions (Circle 2), ROI 3 located in the NAWM regions far from the lesions (Circle 3). For the color maps (C–F), red color represents a high value, blue color represents a low value. Abbreviations: CBF, cerebral blood flow; CBV, cerebral blood volume; Ktrans, volume transfer constant; NAWM, normal-appearing white matter; ROI, region of interest; RRMS, relapsing–remitting multiple sclerosis; Vp, fractional plasma volume.
Figure 3
Figure 3
The histogram of Ktrans in CE lesions (A) and NE lesions (B). Note: The skewness of Ktrans in CE lesions increased to the right side of histogram, while the histogram of Ktrans in NE lesions was more close to normal distribution. Abbreviations: CE, contrast-enhancing; Ktrans, volume transfer constant; NE, non-enhancing.
Figure 4
Figure 4
The skewness and kurtosis of different parameters. Note: The skewness and kurtosis of Ktrans in CE lesions were significantly higher than NE lesions (A), while no significant differences were found in terms of Vp, CBF, and CBV (B–D). Abbreviations: CBF, cerebral blood flow; CE, contrast-enhancing; CBV, cerebral blood volume; Ktrans, volume transfer constant; NE, non-enhancing; Vp, fractional plasma volume.
See this image and copyright information in PMC

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