Quantitative Magnetic Resonance Imaging Analysis of Early Markers of Upper Cervical Cord Atrophy in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

Iman Adibi; Afshin Najafi; Fouad Merajifar; Neda Ramezani; Hosein Nouri; Nassim Jalilvand; Fereshteh Ashtari; Alireza Vard; Vahid Shaygannejad

doi:10.1155/2021/9917582

Quantitative Magnetic Resonance Imaging Analysis of Early Markers of Upper Cervical Cord Atrophy in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

Mult Scler Int. 2021 Jul 9:2021:9917582. doi: 10.1155/2021/9917582. eCollection 2021.

Authors

Iman Adibi^{1

2}, Afshin Najafi², Fouad Merajifar¹, Neda Ramezani¹, Hosein Nouri^{1

3}, Nassim Jalilvand¹, Fereshteh Ashtari^{1

2}, Alireza Vard^{4

5}, Vahid Shaygannejad^{1

2}

Affiliations

¹ Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran.
⁴ Department of Bioelectrics and Biomedical Engineering, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Purpose: To quantitatively analyze the C2/C3 segments of the spinal cord on magnetic resonance imaging (MRI) scans of neuromyelitis optica spectrum disorder (NMOSD) and relapsing-remitting multiple sclerosis (RRMS) patients in their first five years of the disease and to investigate the intergroup differences regarding markers of spinal cord atrophy and their correlations with expanded disability status scale (EDSS).

Materials and methods: Twenty NMOSD patients and twenty RRMS patients, within their first five years of the disease, were enrolled in this cross-sectional study. All patients underwent spinal cord MR imaging using 1.5 Tesla systems, and C2/C3 portions of the spinal cord were segmented in the obtained scans. C2/C3 anteroposterior diameter (C2/C3 SC-APD), transversal diameter (C2/C3 SC-TD), and cross-sectional area (C2/C3 SC-CSA) were quantitatively measured using Spinal Cord Toolbox v.4.3.

Results: Three NMOSD patients were seropositive for anti-AQP4 IgG. The mean C2/C3 SC-CSA in NMOSD patients was significantly lower than in RRMS patients. NMOSD patients had significantly lower C2/C3 SC-TDs than RRMS patients. With the three anti-AQP4+ patients excluded from the analysis, C2/C3 SC-TD was negatively correlated with EDSS.

Conclusion: In the early stages of the disease, quantitative evaluation of C2/C3 spinal cord parameters, including cross-sectional area and transversal diameter in NMOSD patients, appears to be of potential diagnostic and prognostic value.