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Diffusion Tensor Imaging and T 2 Relaxometry in primary Sjogren’s Sundrome

Diffusion Tensor Imaging and T 2 Relaxometry in primary Sjogren’s Sundrome. TZAROUCHI LC 1 , TSIFETAKI N 2 , KONITSIOTIS S 3 , ASTRAKAS LG 4 , ZIKOU AK 1 , ΒΟ TZORIS V 2 , DROSOS A 2 , ARGYROPOULOU MI 1. DEPARTMENT OF RADIOLOGY DEPERTMENT OF RHEUMATOLOGY DEPARTMENT OF NEUROLOGY

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Diffusion Tensor Imaging and T 2 Relaxometry in primary Sjogren’s Sundrome

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  1. Diffusion Tensor Imaging and T2 Relaxometry in primary Sjogren’sSundrome TZAROUCHI LC1, TSIFETAKI N2, KONITSIOTIS S 3, ASTRAKAS LG4, ZIKOU AK1, ΒΟTZORIS V 2, DROSOS A 2, ARGYROPOULOU MI1 DEPARTMENT OF RADIOLOGY DEPERTMENT OF RHEUMATOLOGY DEPARTMENT OF NEUROLOGY DEPARTMENT OF MEDICAL PHYSICS MEDICAL SCHOOL, UNIVERSITY OF IOANNINA, GREECE

  2. INTRODUCTION Sjogren’s Syndrome2-3 %adult population Autoimmune disorder Glandular, extra-glandular manifestations Central Nervous System involvement ? 1-25%, neurological or psychiatric symptoms • Primary (pSS) • Secondary Ann Rheum Dis. 2004 Jun;63(6):616-20

  3. INTRODUCTION • MRI studies T2/FLAIR : white matter hyperintensities (WMHIs) • SPECT studies perfusion • Tzarouchi et al (ECR 2009): 52 pSS/35 controls • WMHIs 80.8%/48.6% • Voxel-Based Morphometry (VBM) Grey matter atrophy White matter atrophy

  4. INTRODUCTION • Relaxometry: measurment of transverse T2 relaxation time • tissue properties (e.g. water, protein, iron content, • gliosis) • Diffusion Tensor Imaging: fractional anisotropy index (FA) • tissue microstructural changes, tracking white matter fibers

  5. PURPOSE To assess in pSS: T2 relaxation time (T2) Fractional anisotropy index (FA) Voxel Based Relaxometry (VBR) Voxel Based Diffusion Tensor Imaging

  6. MATERIALS AND METHODS Ι Study population 32patients with pSS Aged: 64.56±15.6 years Disease Duration: 10.5±5.75 years 18age-matched controls Exclusion criteria: Head trauma, neuropsychiatric disorder, uncontrolled hypertension, diabetes mellitus, blood dyscrasias, metabolic disorders or renal, hepatic or respiratory failure, smoking habits, alcohol intake, migraine

  7. MATERIALS AND METHODS ΙΙ 1.5 Teslaunit, headcoil Multi-slice, spin-echo planar diffusion tensor pulse sequence (TE=131 msec, TR=9807 msec, matrix size=112 x 128, thickness=3 mm, FOV=230 mm, max b-value=700 sec/mm2, 16 non-collinear directions) Multi-echo , multi-slice T2-weighted (TR=2200 sec, TE=32-112 sec, thickness=5 mm, gap=0.5, acquisition matrix=156, reconstruction matrix=256)

  8. Voxel-Based Relaxometry data postprocessing SPM 5.0 software Smoothing Normalisation T2 maps MNI template P < 0.05 FWE correction

  9. Voxel-Based DTI – data postprocessing DTI studio SPM 5.0software b0 image Normalization FA map Smoothing Normalization P < 0.05 FWE correction

  10. VBR RESULTS

  11. Voxel-Based DTI results

  12. DISCUSSION Ι Does brain atrophy affect T2 time Biological Parametring Mapping (BPM) Analysis of Covariance (ANCOVA) VBR data: primary modality VBM data: imaging regressors T2 relaxation time ? *Neuroimage(2007); 34(1): 137-43

  13. VBR results ANCOVA results

  14. DISCUSSION ΙΙ fractional anisotropy • Early white matter damage • Small vessel vasculitis • or • Degenerative process due to grey matter atrophy * RheumatolInt 2003; 23:174-177 * J Nuclear Med 1998; 39:8

  15. CONCLUSION In primary Sjogren’s Syndrome: • Brain atrophy affects T2 relaxation time measurments • Diffusion tensor imaging detects early white matter lesions

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