The features of cerebral permeability and perfusion detected by dynamic contrast-enhanced magnetic resonance imaging with Patlak model in relapsing–remitting multiple sclerosis

OBJECTIVE: To investigate the features of cerebral permeability and perfusion detected by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with Patlak model in relapsing–remitting multiple sclerosis (RRMS) and their correlations with Expanded Disability Status Scale (EDSS) scores and disease duration. PATIENTS AND METHODS: Twenty-seven RRMS patients underwent conventional MRI and DCE-MRI with 3.0 T magnetic resonance scanner were enrolled in the study. A Patlak model was used to quantitatively measure MRI biomarkers, including volume transfer constant (K(trans)), fractional plasma volume (V(p)), cerebral blood flow (CBF), and cerebral blood volume (CBV). The correlations of MRI biomarkers with EDSS scores and disease duration were analyzed. RESULTS: The MRI biomarkers K(trans), V(p), CBF, and CBV of contrast-enhancing (CE) lesions were significantly higher (P<0.05) than those of non-enhancing (NE) lesions and normal-appearing white matter (NAWM) regions. The skewness and kurtosis of K(trans) values in CE lesions were significantly higher (P<0.05) than that of NE lesions. No significant correlation was found among the biomarkers with EDSS scores and disease duration (P>0.05). CONCLUSION: Our study demonstrated the abnormalities of permeability and perfusion characteristics in multiple sclerosis (MS) lesions and NAWM regions by DCE-MRI with Patlak model. The K(trans), V(p), CBF, and CBV of CE lesions were significantly higher than that of NE lesions, but these MRI biomarkers did not associate with the severity and duration of the disease. The skewness and kurtosis of K(trans) value in CE lesions were significantly higher than that in NE lesions, indicating that these parameters of K(trans) histogram can be used to distinguish the pathology of MS lesions.