Clinical Implications of Focal Mineral Deposition in the Globus Pallidus on CT and Quantitative Susceptibility Mapping of MRI

Abstract

Objective To assess focal mineral deposition in the globus pallidus (GP) by CT and quantitative susceptibility mapping (QSM) of MRI scans and evaluate its clinical significance, particularly cerebrovascular degeneration. Materials and Methods This study included 105 patients (66.1 ± 13.7 years; 40 male and 65 female) who underwent both CT and MRI with available QSM data between January 2017 and December 2019. The presence of focal mineral deposition in the GP on QSM (GP QSM ) and CT (GP CT ) was assessed visually using a three-point scale. Cerebrovascular risk factors and small vessel disease (SVD) imaging markers were also assessed. The clinical and radiological findings were compared between the different grades of GP QSM and GP CT . The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. Results GP CT and GP QSM were significantly associated ( p < 0.001) but were not identical. Higher GP CT and GP QSM grades showed smaller gray matter ( p = 0.030 and p = 0.025, respectively) and white matter ( p = 0.013 and p = 0.019, respectively) volumes, as well as larger GP volumes ( p < 0.001 for both). Among SVD markers, white matter hyperintensity was significantly associated with GP CT ( p = 0.006) and brain atrophy was significantly associated with GP QSM ( p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GP CT ( p < 0.001) and GP QSM ( p = 0.002), while the normalized volume of the GM was independently negatively associated with GP CT ( p = 0.040) and GP QSM ( p = 0.035). Conclusion Focal mineral deposition in the GP on CT and QSM might be a potential imaging marker of cerebral vascular degeneration. Both were associated with increased GP volume.

Layer-Specific Vulnerability is a Mechanism of Topographic Map Aging

“…In addition to age-related increases in iron, we also demonstrate that the superficial layer and layer 5a of M1 show lower nQSM (that is, more substance) in older adults compared to younger adults. The biological source of nQSM is currently under debate but has been shown to reflect myelin (Deh et al, 2018) and calcium (Wang et al, 2017; Jang et al, 2021; Kim et al, 2022). Our data support the latter interpretation, by showing age-related increase in nQSM signal (i.e.…”

“…While previous studies have highlighted the vulnerability of M1 to age-related iron accumulation (Hallgren & Sourander, 1958;Acosta-Cabronero et al, 2016;Betts et al, 2016) In addition to age-related increases in iron, we also demonstrate that the superficial layer and layer 5a of M1 show lower nQSM (that is, more substance) in older adults compared to younger adults. The biological source of nQSM is currently under debate but has been shown to reflect myelin (Deh et al, 2018) and calcium (Wang et al, 2017;Jang et al, 2021;Kim et al, 2022).…”

“…Together with functional localisers, we extracted microstructural profiles of the major cortical fields of M1 (lower limb (LL), upper limb (UL), face (F)) (termed according to Glasser et al, 2017). Age-related differences in pQSM and nQSM values were of particular interest, since previous studies have shown increased iron (Acosta-Cabronero et al, 2016; Betts et al, 2016) and calcium (Jang et al, 2021; Kim et al, 2022) in aging. Increased iron has been related to poorer motor function in healthy older adults (Sullivan et al, 2009), whereas the biological source of the nQSM signal is currently under debate (see more details in the discussion).…”

Value of Quantitative Susceptibility Mapping in Clinical Neuroradiology

“…This finding was evaluated histopathologically, demonstrating the presence of iron and calcification at the vascular wall of the globus pallidus. 43 This may be because calcification at the vascular wall shows high attenuation on CT, and positive susceptibility in relation to iron overwhelms the negative susceptibility associated with calcification on QSM. 44 Meanwhile, paramagnetic substances such as iron shows a lesser effect on CT attenuation.…”

Brain Iron Imaging in Aging and Cognitive Disorders: MRI Approaches

“…시신을 이용한 영상 및 병리 비교 연구에 따르면, 이는 창백핵 내측에 위치하는 혈관 벽의 철 및 석회질의 동시 침착으로, 혈관의 노화 역시 MRI 상 뇌의 특정 부위에 철 침착의 소견을 보일 수 있으며( 23 ), CT와 철 영상 기법을 복합적으로 이용하여 확인 가능하다. 이러한 소견은 나이에 따라 정도가 증가할 뿐 아니라 뇌혈관 위험인자들과의 연관성도 제시되어 추후 뇌혈관 질환의 영상 표지자로서 가능성이 제시되고 있다( 24 ).…”