BACKGROUND: Putaminal iron deposition is a histopathological feature of multiple system atrophy (MSA), which is not observed in patients with idiopathic Parkinson's disease (PD). T2*-weighted magnetic resonance imaging (MRI) gradient echo (GE) sequences are sensitive for paramagnetic susceptibility changes and therefore may support the clinical differential diagnosis between MSA and PD. METHODS: We evaluated putaminal signal intensities on 1.0 Tesla scans of 52 MSA patients, 88 patients with PD and 29 healthy control subjects. RESULTS: The typical finding in T2* GE sequences of MSA patients was a signal loss of the dorsolateral putamen, which showed a high specificity (>0.91), but was present in only a subpopulation of patients (sensitivity 0.64-0.69). The combination of the latter with additional presence of a hyperintense lateral rim in fluid attenuated inversion recovery (FLAIR) sequences increased the specificity to 0.97. Using a quantitative evaluation of putaminal signal intensities in defined regions of interest MSA and PD could be discriminated with a diagnostic accuracy (r) of up to 0.82. CONCLUSION: Although the separation of groups remains incomplete, the use of T2*-weighted GE sequences combined with FLAIR may be helpful for the differential diagnosis of MSA versus PD considering its fast application, easy evaluation, broad availability, the specificity of findings and the presence of putaminal signal loss already at early disease stages.
BACKGROUND: Putaminal iron deposition is a histopathological feature of multiple system atrophy (MSA), which is not observed in patients with idiopathic Parkinson's disease (PD). T2*-weighted magnetic resonance imaging (MRI) gradient echo (GE) sequences are sensitive for paramagnetic susceptibility changes and therefore may support the clinical differential diagnosis between MSA and PD. METHODS: We evaluated putaminal signal intensities on 1.0 Tesla scans of 52 MSA patients, 88 patients with PD and 29 healthy control subjects. RESULTS: The typical finding in T2* GE sequences of MSA patients was a signal loss of the dorsolateral putamen, which showed a high specificity (>0.91), but was present in only a subpopulation of patients (sensitivity 0.64-0.69). The combination of the latter with additional presence of a hyperintense lateral rim in fluid attenuated inversion recovery (FLAIR) sequences increased the specificity to 0.97. Using a quantitative evaluation of putaminal signal intensities in defined regions of interest MSA and PD could be discriminated with a diagnostic accuracy (r) of up to 0.82. CONCLUSION: Although the separation of groups remains incomplete, the use of T2*-weighted GE sequences combined with FLAIR may be helpful for the differential diagnosis of MSA versus PD considering its fast application, easy evaluation, broad availability, the specificity of findings and the presence of putaminal signal loss already at early disease stages.
Authors: M Plotkin; H Amthauer; S Klaffke; A Kühn; L Lüdemann; G Arnold; K-D Wernecke; A Kupsch; R Felix; S Venz Journal: J Neural Transm (Vienna) Date: 2004-09-14 Impact factor: 3.575
Authors: Klaus Seppi; Michael F H Schocke; Eveline Donnemiller; Regina Esterhammer; Christian Kremser; Christoph Scherfler; Anja Diem; Werner Jaschke; Gregor K Wenning; Werner Poewe Journal: Mov Disord Date: 2004-12 Impact factor: 10.338
Authors: A Schrag; D Kingsley; C Phatouros; C J Mathias; A J Lees; S E Daniel; N P Quinn Journal: J Neurol Neurosurg Psychiatry Date: 1998-07 Impact factor: 10.154
Authors: Y Wang; S R Butros; X Shuai; Y Dai; C Chen; M Liu; E M Haacke; J Hu; H Xu Journal: AJNR Am J Neuroradiol Date: 2011-11-03 Impact factor: 3.825
Authors: Michael C Kruer; Mark Hiken; Allison Gregory; Alessandro Malandrini; David Clark; Penny Hogarth; Marjorie Grafe; Susan J Hayflick; Randall L Woltjer Journal: Brain Date: 2011-04 Impact factor: 13.501
Authors: I Hwang; C-H Sohn; K M Kang; B S Jeon; H-J Kim; S H Choi; T J Yun; J-H Kim Journal: AJNR Am J Neuroradiol Date: 2015-09-03 Impact factor: 3.825