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UBC Theses and Dissertations

Application of myelin water imaging to detect diffuse white matter damage in multiple sclerosis Lee, Eun Young (Lisa)


While conventional magnetic resonance imaging (MRI) is qualitatively useful for the diagnosis and clinical management of multiple sclerosis (MS), it has limitations in terms of detecting specific myelin loss and diffuse damage in the normal-appearing white matter. A non-conventional MRI technique, called myelin water imaging (MWI) can be achieved using multicomponent T₂ relaxation to provide a quantitative in vivo measurement of myelin, termed myelin water fraction (MWF). MWF has been proposed as a candidate MR marker of myelin content in the central nervous system. In this study, I present the application of MWI to gain a deeper insight into the diffuse white matter damage in MS. First, we found lower myelin content and higher myelin heterogeneity in brain and cervical spinal cord, as well as correlations between myelin heterogeneity and clinical disability in cervical spinal cord in progressive MS compared to healthy controls. We also found myelin abnormalities in the regional and global white matter in progressive solitary sclerosis, which has recently been proposed as a potential variant of MS. Finally, we demonstrated good global white matter MWF reproducibility (coefficient of variation = 2.77 %; Pearson’s r = 0.91, p < 0.001; mean bias = 0.002) between two sites using different scanner vendors. Together, our findings support that MWI is a useful quantitative imaging technique that may be used to improve our understanding of the pathological processes in MS. Furthermore, inter-vendor reproducibility takes MWI a step closer to routine use for multicenter studies and clinical applications.

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