A Distinct MR Imaging Phenotype in Amyotrophic Lateral Sclerosis: Correlation between T1 Magnetization Transfer Contrast Hyperintensity along the Corticospinal Tract and Diffusion Tensor Imaging Analysis

G. Carrara; C. Carapelli; F. Venturi; M.M. Ferraris; L. Lequio; A. Chiò; A. Calvo; S. Sirgiovanni; A. Cistaro; M.C. Valentini

doi:10.3174/ajnr.A2855

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Fig 1.
T1 MTC MR sagittal (A and B) and axial (C) images show a hyperintense signal intensity along the CST and in the posterior aspect of the CC (B).
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Fig 2.
Blue voxels show the regions within and outside the CST, where the FA is significantly reduced in patients with ALS with T1 MTC hyperintense signal intensity compared with patients with ALS without T1 MTC hyperintense signal intensity (all P values < .05, corrected at the cluster level). Red voxels show the regions where the FA is significantly increased in patients with ALS with T1 MTC hyperintense signal intensity compared with patients with ALS without T1 MTC hyperintense signal intensity (all P values < .05, corrected at cluster level). In the CC, patients with T1 MTC hyperintense signal intensity compared with patients without T1 MTC hyperintensity show a significantly lower FA only in the posterior aspect of the body of the CC, whereas they show higher FA in the entire CC, in the splenium, in the genu, and in the anterior body.

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Table 1:
Sensitivity and specificity of T1 MTC hyperintense signal in patients with ALS and controls
Patients with ALS Controls
T1 MTC hyperintensity
Present 16 0
Absent 27 43
Sensitivity (%) 37.2
Specificity (%) 100
Positive predictive value 1
Negative predictive value 0.61

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Table 2:

Mean FA of clusters with statistically significant differences between patients with ALS with T1 MTC hyperintense signal and those without it and controls^a

	Patients with ALS		Controls
	MT Hyperintensity	No MT Hyperintensity	Controls
Entire CST	0.403 (0.024)	0.432 (0.022)	0.454 (0.024)
CST including internal capsule	0.373 (0.024)	0.411 (0.021)	0.431 (0.024)
Middle cerebellar peduncles	0.435 (0.020)	0.464 (0.019)	0.480 (0.020)
Pons	0.414 (0.014)	0.427 (0.014)	0.445 (0.015)
Entire CC	0.580 (0.018)	0.569 (0.018)	0.619 (0.019)
Genu CC	0.517 (0.022)	0.499 (0.022)	0.549 (0.023)
Body CC	0.530 (0.014)	0.524 (0.014)	0.584 (0.015)
Anterior body CC	0.532 (0.013)	0.514 (0.013)	0.571 (0.014)
Posterior body CC	0.528 (0.015)	0.536 (0.015)	0.602 (0.016)
Splenium CC	0.679 (0.015)	0.665 (0.015)	0.706 (0.015)
Temporal white matter	0.268 (0.013)	0.245 (0.012)	0.281 (0.013)
Parietal white matter	0.236 (0.016)	0.212 (0.015)	0.255 (0.016)
Frontal white matter	0.243 (0.014)	0.234 (0.013)	0.259 (0.014)