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Research ArticleAdult Brain
Open Access

Measuring Brain Tissue Integrity during 4 Years Using Diffusion Tensor Imaging

D. Ontaneda, K. Sakaie, J. Lin, X.-F. Wang, M.J. Lowe, M.D. Phillips and R.J. Fox
American Journal of Neuroradiology January 2017, 38 (1) 31-38; DOI: https://doi.org/10.3174/ajnr.A4946
D. Ontaneda
aFrom the Department of Neurology (D.O., R.J.F.), Neurological Institute, Mellen Center for Multiple Sclerosis Treatment and Research
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K. Sakaie
bImaging Institute (K.S., J.L., M.J.L., M.D.P.)
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J. Lin
bImaging Institute (K.S., J.L., M.J.L., M.D.P.)
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X.-F. Wang
cDepartment of Quantitative Health Sciences (X.-F.W.), Cleveland Clinic Foundation, Cleveland, Ohio.
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M.J. Lowe
bImaging Institute (K.S., J.L., M.J.L., M.D.P.)
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M.D. Phillips
bImaging Institute (K.S., J.L., M.J.L., M.D.P.)
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R.J. Fox
aFrom the Department of Neurology (D.O., R.J.F.), Neurological Institute, Mellen Center for Multiple Sclerosis Treatment and Research
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    Fig 1.

    ROIs in infratentorial (A), posterior periatrial (B), corpus callosum (C), and juxtacortical (D) lesional tissues on postcontrast T2-weighted images. Note ROIs in normal-appearing white matter locations (E–I) on fractional anisotropy maps.

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    Fig 2.

    Baseline DTI characteristics of normal-appearing white matter, non-black holes, black holes, and gadolinium-enhancing lesions for radial diffusivity (A), axial diffusivity (B), fractional anisotropy (C), and mean diffusivity (D). Boxplots show median (dark line), upper and lower quartiles (box), maximum and minimum values excluding outliers (whiskers), and outliers (circles).

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    Fig 3.

    Longitudinal evolution of DTI metrics during 4 years for, non-black holes, black holes, and gadolinium-enhancing lesions for radial diffusivity (A), axial diffusivity (B), fractional anisotropy (C), and mean diffusivity (D). Mean values (symbol) and 95% confidence intervals (error bars) are presented. Statistical significance and effect from the mixed-model effect are presented in boxes.

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    Table 1:

    Longitudinal DTI changes in NAWM and GAD

    Change/Month95% CI% Annualized ChangeP Value
    NAWM
        RD × 10−6 mm2/s0.2193−0.187 to 0.6250.57%.2898
        AD × 10−6 mm2/s−0.2109−0.614 to 0.192−0.21%.3052
        FA × 10−3−0.2572−0.551 to 0.037−0.57%.0865
        MD × 10−6 mm2/s0.03209−0.331 to 0.3960.05%.8626
    GAD
        RD × 10−6 mm2/s0.61070.039 to 1.2851.22%.0374
        AD × 10−6 mm2/s1.88311.135 to 2.6312.25%<.0001a
        FA × 10−30.50740.031 to 0.9842.10%.037
        MD × 10−6 mm2/s1.27880.695 to 1.8632.00%<.0001a
    • ↵a P < .05.

    • View popup
    Table 2:

    Longitudinal DTI changes in chronic lesional tissue

    Change/Month95% CI% Annualized ChangeP Value
    All T2 lesions
        RD × 10−6 mm2/s0.05683−0.181 to 0.2950.11%.6401
        AD × 10−6 mm2/s0.54110.251 to 0.8310.62%.0003a
        FA × 10−30.1630.001 to 0.3240.61%.0482a
        MD ×10−6 mm2/s0.26950.040 to 0.4990.41%.0211a
    BH
        RD × 10−6 mm2/s0.3392−0.028 to 0.7060.57%.0701
        AD × 10−6 mm2/s0.1967−0.200 to 0.5930.22%.331
        FA × 10−3−0.2137−0.422 to −0.005−0.91%.0444
        MD × 10−6 mm2/s0.2919−0.059 to 0.6430.42%.1026
    NBH
        RD ×10−6 mm2/s−0.4137−0.967 to 0.140−0.85%.1432
        AD × 10−6 mm2/s−0.2392−0.838 to 0.360−0.28%.434
        FA × 10−30.2907−0.025 to 0.6060.99%.0708
        MD × 10−6 mm2/s−0.355−0.174 to 0.884−0.58%.1883
    • ↵a P < .05.

    • View popup
    Table 3:

    Analysis of variance of fixed effects on longitudinal changes comparing evolution of DTI metrics from different tissue types during 4 years

    P Value
    NAWM vs GAD
        RD.11
        AD<.001a
        FA.004a
        MD<.001a
    NAWM vs T2 lesions
        RD.15
        AD.002a
        FA.09
        MD.037
    BH vs NBH
        RD.36
        AD.39
        FA.01a
        MD.07
    • ↵a P < .05.

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American Journal of Neuroradiology: 38 (1)
American Journal of Neuroradiology
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Measuring Brain Tissue Integrity during 4 Years Using Diffusion Tensor Imaging
D. Ontaneda, K. Sakaie, J. Lin, X.-F. Wang, M.J. Lowe, M.D. Phillips, R.J. Fox
American Journal of Neuroradiology Jan 2017, 38 (1) 31-38; DOI: 10.3174/ajnr.A4946
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D. Ontaneda, K. Sakaie, J. Lin, X.-F. Wang, M.J. Lowe, M.D. Phillips, R.J. Fox
Measuring Brain Tissue Integrity during 4 Years Using Diffusion Tensor Imaging
American Journal of Neuroradiology Jan 2017, 38 (1) 31-38; DOI: 10.3174/ajnr.A4946

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