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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleSpine Imaging and Spine Image-Guided Interventions

Cervical Cord Atrophy and Long-Term Disease Progression in Patients with Primary-Progressive Multiple Sclerosis

F.X. Aymerich, C. Auger, J. Alonso, M. Alberich, J. Sastre-Garriga, M. Tintoré, X. Montalban and A. Rovira
American Journal of Neuroradiology February 2018, 39 (2) 399-404; DOI: https://doi.org/10.3174/ajnr.A5495
F.X. Aymerich
aFrom the Magnetic Resonance Unit (F.X.A., C.A., J.A., M.A., A.R.), Department of Radiology
cDepartment of Automatic Control (F.X.A.), Universitat Politècnica de Catalunya–Barcelona Tech, Barcelona, Spain.
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  • ORCID record for F.X. Aymerich
C. Auger
aFrom the Magnetic Resonance Unit (F.X.A., C.A., J.A., M.A., A.R.), Department of Radiology
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J. Alonso
aFrom the Magnetic Resonance Unit (F.X.A., C.A., J.A., M.A., A.R.), Department of Radiology
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M. Alberich
aFrom the Magnetic Resonance Unit (F.X.A., C.A., J.A., M.A., A.R.), Department of Radiology
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J. Sastre-Garriga
bCentre d'Esclerosi Múltiple de Catalunya (J.S.-G., M.T., X.M.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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M. Tintoré
bCentre d'Esclerosi Múltiple de Catalunya (J.S.-G., M.T., X.M.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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X. Montalban
bCentre d'Esclerosi Múltiple de Catalunya (J.S.-G., M.T., X.M.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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A. Rovira
aFrom the Magnetic Resonance Unit (F.X.A., C.A., J.A., M.A., A.R.), Department of Radiology
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    Fig 1.

    An example of the cord surface estimation obtained using the active surface method. The upper left image shows the location of the landmarks (red markers) that can be visualized in this sagittal slice. These landmarks were manually placed in the axial slices at the center area of the cord with a distance between them of approximately 10 mm. The upper right image shows the cord outline estimation (red lines). The lower axial slices show some examples of the spinal cord segmentation obtained (region within red contour).

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    Fig 2.

    Box-and-whisker plots of normalized cross-sectional areas: NMCSA (upper left), NCSA23 (upper right), NCSA34 (lower left), and NCSA45 (lower right).

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    Table 1:

    Main baseline demographic, clinical, and conventional MRI characteristics

    Patients with MS
    Median age (range) (yr)51 (33–61)
    Men/women19:12
    Mean disease duration at baseline (range) (yr)11.74 (2–33)
    Median EDSS score at baseline (range)5.5 (3.0–6.5)
    Mean brain T2LV at baseline (SD) (mL)18.12 (20.63)
    Mean brain T1LV at baseline (SD) (mL)7.41 (8.47)
    Mean BPF at baseline (SD)73.13% (5.86%)
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    Table 2:

    Evolution of the EDSS

    Baseline2 Years14 Years
    Median EDSS score (range)5.5 (3.0–6.5)6.0 (4.0–8.5)7.5 (4.0–9.5)
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    Table 3:

    MRI characteristics at follow-up

    Follow-Up
    Mean brain T2LV (SD) (mL)21.56 (20.65)
    Mean brain T1LV (SD) (mL)9.53 (9.32)
    Mean BPF (SD)70.33% (5.84%)
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    Table 4:

    Longitudinal cross-sectional area measurements

    NMCSANCSA23NCSA34NCSA45
    Mean at baseline (SD) (mm2)71.49 (6.37)67.76 (7.26)68.21 (7.39)71.51 (8.27)
    Mean at follow-up (SD) (mm2)68.12 (8.91)65.40 (10.27)65.23 (10.61)67.95 (9.97)
    Cord area change averaged by year (SD) (%)−0.77 (1.14)−0.62 (1.20)−0.74 (1.47)−0.77 (1.61)
    P value.001.006.009.006
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American Journal of Neuroradiology: 39 (2)
American Journal of Neuroradiology
Vol. 39, Issue 2
1 Feb 2018
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Cite this article
F.X. Aymerich, C. Auger, J. Alonso, M. Alberich, J. Sastre-Garriga, M. Tintoré, X. Montalban, A. Rovira
Cervical Cord Atrophy and Long-Term Disease Progression in Patients with Primary-Progressive Multiple Sclerosis
American Journal of Neuroradiology Feb 2018, 39 (2) 399-404; DOI: 10.3174/ajnr.A5495

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Cervical Cord Atrophy and Long-Term Disease Progression in Patients with Primary-Progressive Multiple Sclerosis
F.X. Aymerich, C. Auger, J. Alonso, M. Alberich, J. Sastre-Garriga, M. Tintoré, X. Montalban, A. Rovira
American Journal of Neuroradiology Feb 2018, 39 (2) 399-404; DOI: 10.3174/ajnr.A5495
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