Usefulness of two-dimensional measurements for the evaluation of brain volume and disability in multiple sclerosis

Abstract

Background Two-dimensional (2D) measures have been proposed as potential proxies for whole-brain volume in multiple sclerosis (MS). Objective To verify whether 2D measurements by routine MRI are useful in predicting brain volume or disability in MS. Methods In this cross-sectional analysis, eighty-five consecutive Japanese MS patients—relapsing-remitting MS (81%) and progressive MS (19%)—underwent 1.5 Tesla T1-weighted 3D MRI examinations to measure whole-brain and grey matter volume. 2D measurements, namely, third ventricle width, lateral ventricle width (LVW), brain width, bicaudate ratio, and corpus callosum index (CCI), were obtained from each scan. Correlations between 2D measurements and 3D measurements, the Expanded Disability Status Scale (EDSS), or processing speed were analysed. Results The third and lateral ventricle widths were well-correlated with the whole-brain volume ( p < 0.0001), grey matter volume ( p < 0.0001), and EDSS scores ( p = 0.0001, p = .0004, respectively).The least squares regression model revealed that 78% of the variation in whole-brain volume could be explained using five explanatory variables, namely, LVW, CCI, age, sex, and disease duration. By contrast, the partial correlation coefficient excluding the effect of age showed that the CCI was significantly correlated with the EDSS and processing speed ( p < 0.0001). Conclusion Ventricle width correlated well with brain volumes, while the CCI correlated well with age-independent (i.e. disease-induced) disability.

Predictors of multiple sclerosis progression: A systematic review of conventional magnetic resonance imaging studies

“…In white matter (WM), EDSS score was significantly correlated with WM lesion volume, central atrophy, lesion probability in the periventricular WM at the left frontal horn and around the posterior horns and with whole-brain volume particularly with widths of third and lateral ventricle [32,37,[43][44][45]. The presence of confluent lesions (in RRMS), higher number of T2 lesions, lower baseline T2-lesion volume (T2LV), lower normalized brain volume (NBV), higher percentage brain volume change (PBVC) between year 2 and baseline and presence of � 4 slowly expanding lesions (SELs) were defined as prognostic factors for EDSS worsening and disability progression [46][47][48]83].…”

Differences in Brain Atrophy Pattern between People with Multiple Sclerosis and Systemic Diseases with Central Nervous System Involvement Based on Two-Dimensional Linear Measures

“…In vivo brain atrophy is usually estimated by measurement of brain volume (BV) change [8,17,18]. Assessment of brain atrophy on MRI with the use of two-dimensional linear measurements (2DLMs), including bicaudate ratio (BCR), corpus callosum index (CCI) and width of third ventricle (W3V), has been proposed as an easy-to-use alternative in daily clinical routine [19][20][21]. BCR is suggested as a marker of deep frontal subcortical white matter atrophy, CCI is an accepted measurement of local white matter atrophy and W3V reflects central brain atrophy [19][20][21].…”

“…Assessment of brain atrophy on MRI with the use of two-dimensional linear measurements (2DLMs), including bicaudate ratio (BCR), corpus callosum index (CCI) and width of third ventricle (W3V), has been proposed as an easy-to-use alternative in daily clinical routine [19][20][21]. BCR is suggested as a marker of deep frontal subcortical white matter atrophy, CCI is an accepted measurement of local white matter atrophy and W3V reflects central brain atrophy [19][20][21]. Recently published results indicate that 2DLMs applied in clinical practice may be useful as markers of long-term clinical progression and may correlate with neurological and cognitive impairment in MS patients [19][20][21].…”

“…BCR is suggested as a marker of deep frontal subcortical white matter atrophy, CCI is an accepted measurement of local white matter atrophy and W3V reflects central brain atrophy [19][20][21]. Recently published results indicate that 2DLMs applied in clinical practice may be useful as markers of long-term clinical progression and may correlate with neurological and cognitive impairment in MS patients [19][20][21]. Taking into consideration the above-mentioned limitations of conventional MRI, in our work we applied 2DMLs in order to characterize brain atrophy patterns in a group of newly diagnosed MS and SDCNS patients.…”