Dorsolateral nigral hyperintensity on 3.0T susceptibility‐weighted imaging in neurodegenerative Parkinsonism

Reiter, Eva; Mueller, Christoph; Pinter, Bernadette; Krismer, Florian; Scherfler, Christoph; Esterhammer, Regina; Kremser, Christian; Schocke, Michael; Wenning, Gregor K.; Poewe, Werner; Seppi, Klaus

doi:10.1002/mds.26171

Cited by 120 publications

(185 citation statements)

References 51 publications

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“…Therefore, visual reading of NM-sensitive images might be of interest for the diagnosis of idiopathic PD in clinical practice, as suggested previously. 15 We found excellent diagnostic accuracy of DNH loss at 7T for PD characterization, which is in agreement with previous studies at 7T 13,30 and 3T, 14,31 supporting the use of this technique in a clinical setting. 32 Both approaches of visual analysis of DNH, based on the uni-or bilateral presence of DNH loss, resulted in equivalent overall correct classification.…”

Section: Discussionsupporting

confidence: 91%

“…We used 2 classification methods: 1) Unilateral or bilateral absence of DNH was considered pathologic, 20 and 2) only bilateral DNH absence was considered pathologic. 14 …”

Section: Image Analysismentioning

confidence: 99%

“…12 Signal changes in this area have been shown in PD using high-resolution T2*-weighted or susceptibility-weighted imaging at both 7T 13 and 3T. 14 The normal aspect of this dorsolateral region is a hyperintense, ovoid area within the hypointense SN. However, this hyperintensity, referred to as dorsal nigral hyperintensity (DNH), is lost in PD.…”

mentioning

confidence: 99%

“…13,14 Both NM-sensitive and DNH imaging may be useful in clinical practice. [13][14][15] Although these MR imaging techniques have shown good results for differentiating patients from controls either separately 16,17 or by using a combination of diffusion and iron imaging, 3 the comparative diagnostic values of these measures at the individual level remain unclear and have not been tested yet. The aims of our study were to compare the diagnostic efficacy of DTI, R2*, NM-sensitive imaging, and DNH and to determine the best combination of measures to detect specific SN alterations in PD.…”

mentioning

confidence: 99%

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Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease

Pyatigorskaya

Magnin

Mongin

et al. 2018

AJNR Am J Neuroradiol

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Section: Discussionsupporting

confidence: 91%

“…We used 2 classification methods: 1) Unilateral or bilateral absence of DNH was considered pathologic, 20 and 2) only bilateral DNH absence was considered pathologic. 14 …”

Section: Image Analysismentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease

Pyatigorskaya

Magnin

Mongin

et al. 2018

AJNR Am J Neuroradiol

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“…These characteristics render iDESS suitable for applications that require efficient imaging of midbrain nuclei, such as neuronal diseases related to pathological changes in midbrain including Parkinson's disease and progressive supranuclear palsy. [17][18][19] Compared with SPGR, the shortened scan time with similar SNR and CNR brought by iDESS should help to improve the clinical image quality, which is often limited by patients' tolerance to timeconsuming MRI scans.…”

Section: Introductionmentioning

confidence: 99%

Efficient imaging of midbrain nuclei using inverse double‐echo steady‐state acquisition a)

Chang

Chao

et al. 2015

Medical Physics

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Purpose: Imaging of midbrain nuclei using T2-or T2*-weighted MRI often entails long echo time, leading to long scan time. In this study, an inverse double-echo steady-state (iDESS) technique is proposed for efficiently depicting midbrain nuclei. Methods: Thirteen healthy subjects participated in this study. iDESS was performed along with two sets of T2*-weighted spoiled gradient-echo images (SPGR1, with scan time identical to iDESS and SPGR2, using clinical scanning parameters as a reference standard) for comparison. Generation of iDESS composite images combining two echo signals was optimized for maximal contrast-to-noise ratio (CNR) between the red nuclei and surrounding tissues. Signal-to-noise ratios (SNRs) were calculated from the occipital lobe. Comparison was also made using phase-enhanced images as in standard susceptibility-weighted imaging (SWI). Results: The iDESS images present significantly higher SNR efficiency (171.3) than SPGR1 (158.7, p = 0.013) and SPGR2 (95.5, p < 10 −8). iDESS CNR efficiency (19.2) is also significantly greater than SPGR1 (6.9, p < 10) and SPGR2 (14.3, p = 0.0016). Compared with DESS, iDESS provides further advantage on enhanced phase information and hence improved contrast on SWI-processed images. Conclusions: iDESS efficiently depicts midbrain nuclei with improved CNR efficiency, increased SNR efficiency, and reduced scan time and is less prone to susceptibility signal loss from air-tissue interfaces. C 2015 American Association of Physicists in Medicine.

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Nigrosome 1 imaging in REM sleep behavior disorder and its association with dopaminergic decline

Barber

Griffanti

Bradley

et al. 2019

Ann Clin Transl Neurol

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Objectives: Rapid eye movement sleep behavior disorder (RBD) patients have a high risk of developing a Parkinsonian disorder, offering an opportunity for neuroprotective intervention. Predicting near-term conversion, however, remains a challenge. Dopamine transporter imaging, while informative, is expensive and not widely available. Here, we investigate the utility of susceptibility-weighted MRI (SWI) to detect abnormalities of the substantia nigra in RBD, and explore their association with striatal dopaminergic deficits. Methods: SWI of the substantia nigra was performed in 46 RBD patients, 27 Parkinson's patients, and 32 control subjects. Dorsal nigral hyperintensity (DNH) was scored by two blinded raters, and separately quantified using a semiautomated process. Forty-two RBD patients were also imaged with 123 I-ioflupane singlephoton emission computed tomography (DaT SPECT/CT). Results: Consensus visual DNH classification was possible in 87% of participants. 27.5% of RBD patients had lost DNH, compared with 7.7% of control subjects and 96% of Parkinson's patients. RBD patients lacking DNH had significantly lower putamen dopaminergic SPECT/CT activity compared to RBD patients with DNH present (specific uptake ratios 1.89 vs. 2.33, P = 0.002). The mean quantified DNH signal intensity declined in a stepwise pattern, with RBD patients having lower intensity than controls (0.837 vs. 0.877, P = 0.01) but higher than PD patients (0.837 vs. 0.765, P < 0.001). Interpretation: Over one quarter of RBD patients have abnormal substantia nigra SWI reminiscent of Parkinson's, which is associated with a greater dopaminergic deficit. This modality may help enrich neuroprotective trials with early converters.

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Dorsolateral nigral hyperintensity on 3.0T susceptibility‐weighted imaging in neurodegenerative Parkinsonism

Abstract: Visual assessment of dorsolateral nigral hyperintensity on high-field SWI scans may serve as a new simple diagnostic imaging marker for neurodegenerative parkinsonian disorders.

Cited by 120 publications

References 51 publications

Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease

Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease

Efficient imaging of midbrain nuclei using inverse double‐echo steady‐state acquisition a)

Nigrosome 1 imaging in REM sleep behavior disorder and its association with dopaminergic decline

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