Diffusion tensor imaging metrics in diagnosis of HTLV-1-associated myelopathy.

Autor: Liberato de Matos SNF; Immunology Service, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador.; UniFTC, Salvador, Bahia, Brazil., Ladeia-Rocha G; Image Memorial/DASA, Salvador, Bahia, Brazil., Neto JAC; Immunology Service, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador., de Oliveira CJV; Immunology Service, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador., Neto CA; Image Memorial/DASA, Salvador, Bahia, Brazil., Passos L; Immunology Service, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador., Oliveira-Filho J; Neurology Service, Professor Edgard Santos University Hospital, Salvador, Bahia, Brazil.; Instituto de Ciências da Saúde, Federal University of Bahia, Salvador, Bahia, Brazil., Carvalho EM; Immunology Service, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador.; Laboratório de Pesquisas Clínicas (LAPEC), Instituto Gonçalo Moniz, FIOCRUZ, Salvador, Bahia, Brazil.; National Institute of Science and Technology in Tropical Diseases (INCT-DT), CNPq, Brazil.
Jazyk: Spanish; Castilian
Zdroj: Annals of clinical and translational neurology [Ann Clin Transl Neurol] 2022 Apr; Vol. 9 (4), pp. 488-496. Date of Electronic Publication: 2022 Mar 09.
DOI: 10.1002/acn3.51521
Abstrakt: Objective: In the diagnosis of HTLV-1-associated myelopathy (HAM), while magnetic resonance imaging (MRI) is essential to exclude other diseases, its power is limited regarding HAM diagnosis, as only 30% of affected patients present with spinal cord atrophy. Diffusion tensor imaging (DTI) may enable the detection of damage in the white matter microstructure. Here, we quantitatively assess spinal cord damage using DTI and evaluate conventional MRI parameters of the spinal cord in HTLV-1-infected individuals.
Methods: This cross-sectional study involved 33 HTLV-1 carriers, 28 patients with definite-HAM, and 11 seronegative healthy subjects (HS). Region-of-interest (ROI)-based fractional anisotropy (FA) and mean diffusivity (MD) measurements were performed in the upper thoracic and lumbar regions of the spinal cord. Thoracic index was defined as 1/ (anteroposterior diameter × transverse diameter) measured at the fifth 5th vertebral level. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cutoff FA, MD, and thoracic index values.
Results: Spinal cord atrophy was observed in 15 (53.6%) patients with definite-HAM. The area under the ROC curve in the thoracic spinal cord was 0.824 (95% CI, 0.716-0.932), 0.839 (95% CI: 0.736-0.942), and 0.838 (95% CI: 0.728-0.949) for FA, MD, and the thoracic index, respectively. Lower FA and higher MD values were observed in the definite-HAM group compared to HTLV-1 carriers and HS at the T5 vertebral level (p < 0.01).
Interpretation: Complementary to conventional MRI, DTI analysis of the spinal cord and thoracic index determination can offer additional insight that may prove useful in the diagnosis of HAM.
(© 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)
Databáze: MEDLINE
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