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The prevalence and distribution of white-matter changes on different MRI pulse sequences in a post-stroke cohort
R Mäntylä1, H J Aronen, O Salonen
1Department of Radiology, University of Helsinki, Haartmaninkatu 4, FIN-00290 Helsinki, Finland. riitta.mantyla@helsinki.fi
Abstract:
No uniform criteria currently exist for rating white-matter (WM) high-signal foci on MRI. Ratings are based on descriptive terms, different pulse sequences and different WM areas. Reports on the prevalence and clinical correlates of high-signal foci have been contradictory. We wanted to examine the contribution of the pulse sequence and WM area on rating WM changes. We analysed WM changes separately on T2-, protondensity (PD)- and T1-weighted images in periventricular, subcortical, watershed area and deep WM. The difference between T2- and PD-weighted images was significant for frontal caps, counting small foci or analysing subcortical changes. T1-weighted images showed significantly less change, but the number of foci detected was greater than previously thought. The prevalence of WM high-signal foci was greatest in the watershed zone and smallest in the subcortical area. There was a significant correlation between foci in different areas.
Insights
Standardizing MRI ratings for white-matter (WM) high-signal foci is crucial. This study reveals pulse sequence and WM area significantly impact WM change ratings, with watershed zones showing the highest prevalence.
Area of Science:
- Neuroradiology
- Neuroimaging
- White Matter Diseases
Background:
- Current criteria for rating white-matter (WM) high-signal foci on MRI lack uniformity.
- Inconsistent descriptive terms, pulse sequences, and WM areas contribute to contradictory findings on prevalence and clinical correlates.
- The need for standardized assessment of WM changes is evident.
Purpose of the Study:
- To investigate the influence of MRI pulse sequences (T2, proton-density [PD], T1-weighted) on rating WM changes.
- To determine the impact of different WM areas (periventricular, subcortical, watershed, deep WM) on WM change assessment.
- To establish a more consistent approach for evaluating WM abnormalities.
Main Methods:
- Analysis of WM changes on T2-, PD-, and T1-weighted MRI sequences.
- WM changes were evaluated in periventricular, subcortical, watershed, and deep WM regions.
- Comparison of findings across different pulse sequences and WM areas.
Main Results:
- Significant differences in WM change ratings were observed between T2- and PD-weighted images, particularly in frontal caps and subcortical areas.
- T1-weighted images revealed fewer changes but detected a higher number of foci than previously reported.
- The watershed zone exhibited the highest prevalence of WM high-signal foci, while the subcortical area showed the lowest.
Conclusions:
- Pulse sequence and WM area significantly affect the rating of white-matter high-signal foci.
- Standardized imaging protocols and analysis methods are necessary for accurate WM change assessment.
- Findings highlight the importance of considering imaging parameters and anatomical location in interpreting WM abnormalities.