Imaging Analysis Results



Date of MRI (m m/dd/yyyy):T2 lesions analysisTotal volume of brain lesions on T2W image (cc)**:Change in T2 lesion(s) volume (mL)**:Total number of T2 lesions:Number of new or enlarging non-enhancing T2 lesions**:Number of periventricular lesions:Number of juxtacortical lesions:Number of posterior fossa lesions:Number of cortical lesions:Number of thalamus lesions:Number of basal ganglia lesions:Number of other lesions whose type is not specified***:Technique reference for new lesions (i.e. literature citation(s), MRI Acquisition Manual or Analysis Manual. May also include visual observation, detection, etc.):Gd-enhancing lesions analysisTotal number of Gd-enhancing lesions:Number of NEW Gd-enhancing lesions**:Total volume of all Gd-enhancing lesions (cc):Change in volume of all Gd-enhancing lesions (cc):Technique reference (i.e. literature citation(s), MRI Acquisition Manual or Analysis Manual):Combined Unique Active lesionsNumber of CUA lesions compared to previous time-point:Technique reference for new lesions (i.e. literature citation(s), MRI Acquisition Manual or Analysis Manual. May also include visual observation, detection, etc.):T1 hypointense lesions analysisTotal number of T1 hypointense lesions:Number of new T1 hypointense lesions:Total volume of T1 hypointense lesions (mL):Change in volume of T1 hypointense lesions (mL):Technique reference (i.e. literature citation(s), MRI Acquisition Manual or Analysis Manual):Change in brain volume analysis Answer either question 1 or 2, but not both.Brain volume (mL)**: FORMCHECKBOX Not answeredChange in brain volume (mL)**: FORMCHECKBOX mL FORMCHECKBOX %Brain volume fraction**: FORMCHECKBOX Not answeredChange in brain volume fraction (%):Change in ventricular volume analysisAnswer either question 1 or 2, but not both.Ventricular volume (mL): FORMCHECKBOX Not answeredChange in brain volume (mL): FORMCHECKBOX mL FORMCHECKBOX %Ventricular volume fraction: FORMCHECKBOX Not answeredChange in brain volume (mL): FORMCHECKBOX mL FORMCHECKBOX %Gray matter volume analysisAnswer either question 1 or 2, but not both.Gray matter volume (mL)***: FORMCHECKBOX Not answeredChange in gray matter volume (%)***:Gray matter volume fraction***: FORMCHECKBOX Not answeredChange in gray matter volume fraction (%)***:Gray matter lesions analysisNumber of new gray matter lesions:Total number of gray matter lesions:Total volume of gray matter lesions (mL):Change in volume of gray matter lesions (mL)***:Technique reference for new lesions (i.e. literature citation(s), MRI Acquisition Manual or Analysis Manual. May also include visual observation, detection, etc.):White matter volume analysis Answer either question 1 or 2, but not both.White matter volume (mL)***: FORMCHECKBOX Not answeredChange in white matter volume (%)***:White matter volume fraction***: FORMCHECKBOX Not answeredChange in white matter volume fraction (%)***:Change in normal appearing white matter - complete as many times as needed (%)***:Timepoint***: [Add protocol-specific options]Regional volumetric analysisCentral cerebral volume (mL):Change in central cerebral volume (mL):Cortical thickness (mm):Change in cortical thickness (mm):Brain structure volumesHippocampus (mL):Change in hippocampus (mL):Thalamus (mL):Change in thalamus (mL):Spinal cord lesions analysisTotal number of spinal cord lesions***:Spinal cord lesion region (choose all that apply)***: FORMCHECKBOX C1-C7 FORMCHECKBOX T1-T12 FORMCHECKBOX L1-L5Spinal cord lesions location (choose all that apply)***: FORMCHECKBOX Anterior FORMCHECKBOX Posterior FORMCHECKBOX LateralSpinal cord measurement***: FORMCHECKBOX Area (mm2): FORMCHECKBOX Volume (mL):Technique reference (i.e. literature citation(s), MRI Acquisition Manual or Analysis Manual):Tissue Integrity MeasuresMTR – specify units and values TableIntentionally left blankUnitsWhole brainNormal-appearing GMNormal-appearing WMMean MTRData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteMTR histogram peak positionData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteMTR histogram peak heightData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteDTI – specify units and values TableIntentionally left blank.UnitsWhole brainNormal-appearing GMNormal-appearing WMMean FAData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteMean ADCData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteMean axial diffusivityData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteMean radial diffusivityData to be entered by siteData to be entered by siteData to be entered by siteData to be entered by siteGeneral InstructionsThis CRF Module is designed to be used in conjunction with the MRI and Imaging Analysis Technique and Results – Baseline CRF Modules.Investigators should support use of the MS Imaging CRF Modules with detailed procedure, such as may be contained in the SOPs of their individual intuitions, with particular attention to software versions.All elements on this CRF are classified as Supplemental unless otherwise indicated by an asterisk (*) and should be collected if the research team considers them appropriate for their study.**These elements are considered Supplemental – Highly Recommended.*** These elements are considered Exploratory. Specific InstructionsPlease see the Data Dictionary for definitions for each of the data elements included in this CRF Module. ................
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