Results: the majority of patients concluded the MRI exams (99/116). The mean age and standard deviation (SD) was 55.0 (13.6), 56.9 (11.0) and 60.9 (10.3) in SN, AC and UD, respectively. There was no difference between groups regarding age (P = 0.15), sex (0.59), proviral load (P = 0.94), IFN (P = 0.77) and TNF (P = 0.29). SN and AC patients presented higher educational level P = 0.00). The mean (SD) OABSS was 1.05 (0.83) and 7.53 (3.92) in AC and UD, respectively (P<0.01). The median and interquartile range (IQR) of SC thoracic area were 0.40 (0.38 – 0.45), 0.36 (0.33 – 0.40) and 0.33 (0.27 – 0.37) for SN, AC and UD. The difference was statistically significant in SN versus AC (P = 0.01), SN versus UD (P = 0.00) and AC versus UD (P = 0.03). The median (IQR) of SC lumbar area were 0.67 (0.55 – 0.72), 0.59 (0.54 – 0.67), and 0.53 (0.48 – 0.63) for SN, AC and UD, respectively. Statistically significant difference was observed in SN vs UD and AC versus UD (P = 0.02 and P=0.04, respectively). Median (IQR) fractional anisotropy (FA) values of thoracic field were 0.69 (0.58 – 0.70) in SN, 0.64 (0.55 – 0.71) in AC and 0.57 (0.51 – 0.68) in UD, the difference was not statistically significant difference. Median (IQR) of mean diffusivity (MD) of thoracic field was 1.23 (1.08 – 1.41), 1.26 (1.14 – 1.43) and 1.29 (1.12 – 1.43) in NS, AC and UD, respectively (P>0.05). Median (IQR) of FA values of lumbar field were 0.54 (0.51 – 0.62), 0.50 (0.41 – 0.57) and 0.45 (0.41 – 0.52), with statistically significant difference comparing SN and UD (P = 0.00). Median (IQR) DM values in lumbar field were 1.12 (0.92 – 1.35), 0.97 (0.88 – 1.16) and 0.97 (0.88 – 1.20) in SN, AC and UD, respectively, with no statistically significant difference. Conclusion: Patients with urinary disfunction (UD) exhibited lesser values of SC measurements. SC area seems to be more the most reliable parameter in explaining LUTS in HTLV-1 infected patients. We found no difference regarding diffusion tensor image parameters such as FA and MD.