HTLV-I-associated myelopathy/tropical spastic paraparesis: semiautomatic quantification of spinal cord atrophy from 3-dimensional MR images

J Neuroimaging. 2014 Jan-Feb;24(1):74-8. doi: 10.1111/j.1552-6569.2011.00648.x. Epub 2012 Feb 3.

Abstract

Background: Human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a disabling neurological disorder characterized by inflammatory changes in the spinal cord. We used a semiautomatic technique to quantify spinal cord volume from 3-dimensional MR images of patients with HAM/TSP.

Methods: Five patients and 5 matched healthy volunteers (HVs) underwent MRI of the cervical and thoracic spinal cord at 1.5 T. Quantification of the spinal cord volume was obtained from 3-dimensional MR images using a semiautomatic technique based on level sets. An unpaired t-test was used to assess statistical significance.

Results: Significant differences were found between mean spinal cord volume of HVs and HAM/TSP patients. The thoracic spinal cord volume was 14,050 ± 981 mm(3) for HVs and 8,774 ± 2,218 mm(3) for HAM/TSP patients (P = .0079), a reduction of 38%. The cervical spinal cord volume was 9,721 ± 797 mm(3) for HVs and 6,589 ± 897 mm(3) for HAM/TSP patients (P = .0079), a reduction of 32%. These results suggest that atrophy is evident throughout the spinal cord not routinely quantified.

Conclusions: Semiautomatic spinal cord volume quantification is a sensitive technique for quantifying the extent of spinal cord involvement in HAM/TSP.

Keywords: HAM/TSP; HTLV-I; MRI; Spinal cord; atrophy.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Algorithms*
  • Atrophy
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Myelitis / etiology
  • Myelitis / pathology*
  • Paraparesis, Tropical Spastic / pathology*
  • Pattern Recognition, Automated / methods
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Spinal Cord / pathology*