Abstract
A limited amount of research has explored the relationship between clinical status and lesion characteristics in pediatric patients with demyelinating diseases. Although the presence of a demyelinating lesion can be confirmed through Magnetic Resonance Imaging (MRI), studies have shown MRI to have poor correlation with clinical status. However, recently the use of advanced imaging techniques such as Magnetization Transfer Imaging (MTI) has helped to bridge the gap by exploiting demyelination. This study is the first to evaluate the relationship between MTI analysis of the spinal cord and clinical status in pediatric patients with myelitis. An acute TM patient and a sub-acute MS patient were compared to a control group (n=3). The mean MTR values and mean cross-sectional area were lower in the patients compared to the controls. Spearman’s rank correlation analyses revealed a strong, negative correlation between MTR values and motor symptoms (r=-0.87, p=0.03) and MTR values and pain symptoms (r=-0.87, p=0.03). Interestingly, the MTR analysis was more sensitive at the level of injury in the TM patient, while the cross-sectional area analysis was more sensitive in the MS patient. Although the relatively small sample size limits the reliability of the results, the reduced MTR values in patients compared to controls suggests the reproducibility of MTI analysis. With more patients, a future study could validate the feasibility of this technique for clinical use, which will help to improve the diagnosis and treatment for pediatric patients with demyelinating diseases.