The Combination of Hypointense and Hyperintense Signal Changes on T2-Weighted Magnetic Resonance Imaging Sequences

Abstract

Our data suggest that the pattern consisting of hypointense and hyperintense T2 changes within the putamen is a highly specific MRI sign of MSA, while hypointensity alone remains a sensitive, but nonspecific MRI sign of MSA. In clinically doubtful cases, the appearance of a hypointense and hyperintense signal pattern on MRI makes the diagnosis of PD very unlikely, while hypointense signal changes alone do not exclude idiopathic PD.

Different Iron-Deposition Patterns of Multiple System Atrophy with Predominant Parkinsonism and Idiopathetic Parkinson Diseases Demonstrated by Phase-Corrected Susceptibility-Weighted Imaging

“…38,39,41 In the present study, there was no significant difference of iron-deposition patterns in the whole thalamus; however, significantly higher iron deposition in the PT in patients with MSA-P was observed, which corresponded partially to findings in the previous study using T1 and T2 values. 37 To our knowledge, this relationship has not been described before with SWI.…”

Putaminal Hyperintensity on T1-Weighted MR Imaging in Patients with the Parkinson Variant of Multiple System Atrophy

“…Our results show that T1H, T2H, and putaminal atrophy are excellent findings to discriminate patients with MSA-P from patients with PD, patients with PSP, and healthy control subjects in the early stages of disease, though our results failed to show the usefulness of T2 L, in contrast to previous studies. 11 The usefulness of T2H and putaminal atrophy has been reported, 7,10 but T1H has not been described for the diagnosis of MSA-P. In our results, T1H was superior to T2H to differentiate MSA-P, and correlation analysis showed that T1H was not influenced by age in patients or in healthy control subjects, whereas T2H and atrophy correlated with age in healthy subjects.…”

“…The abnormal putaminal findings that characteristically differentiate patients with MSA from those with other parkinsonian disorders and control subjects are well known: a hyperintense putaminal rim on T2-weighted images, putaminal hypointensity on T2-weighted images, and putaminal atrophy. 7,10,11 In some patients, however, an unequivocal diagnosis cannot be made with MR imaging findings alone. 7 In our daily practice, putaminal hyperintensity on T1-weighted images is frequently observed in patients with MSA-P, though this has not been discussed in previous reports.…”

Differentiation of Typical and Atypical Parkinson Syndromes by Quantitative MR Imaging

“…In MSA, hypointensity of the basal ganglia on T2-weighted images is frequently observed, sometimes in combination with a lateral putaminal hyperintensity. 1,2 However at higher magnetic field strengths (3T and above), this pattern can also be found in healthy elderly subjects and its utility is, therefore, debatable. 3 In the recent consensus criteria, those features have not been incorporated, though brain atrophy defined by MR imaging has been included as an additional clinical definition criterion for possible MSA.…”