T2′ imaging indicates decreased tissue metabolism in frontal white matter of MS patients

Background and purpose T2'-Magnetic resonance imaging (MRI) allows estimation of oxygen metabolism in normal appearing white and gray matter (NAWM and NAGM) and is sensitive to local iron deposition. We hypothesized that T2' imaging is feasible in routine use and reveals differences between MS patients and healthy subjects. Methods T2- and T2*-weighted images were acquired in 23 MS patients (Mean age: 36.8, range: 23-58 years) and 23 age-matched healthy subjects. Quantitative T2- and T2*-values were determined in six regions of interest (ROIs). Results The T2' values in thalamus and caudate nucleus were significantly lower in MS patients than in healthy subjects (139 ms vs 157 ms, P < 0.001 and 97 ms vs 115 ms, P < 0.01). The NAWM in the frontal lobe revealed significant higher T2' values than in healthy subjects (217 ms vs 170 ms, P < 0.001). The subcortical NAWM revealed significant lower T2' values than in healthy subjects (174 ms vs 187 ms, P < 0.028). Conclusion T2' values differed significantly between MS patients and healthy subjects. The reduced T2' values in the basal ganglia are presumably related to higher iron concentration whereas the increased T2' in frontal NAWM most probably reflects reduced tissue metabolism. T2' imaging is feasible for routine-use and promising for monitoring therapy effects. Multiple Sclerosis 2009; 15: 701-707. http://msj.sagepub.com