Echo-planar and gradient-echo diffusion MRI of normal brain iron in the globus pallidus

The purpose of this study was to investigate effects of normal brain iron on proton diffusion and its quantification by diffusion MRI. The studies were undertaken in 24 cases ages ranging from 15 to 74 years (mean=45 years) with normal iron deposition in the globus pallidus to characterize the appearances on diffusion imaging with differing b values and on apparent diffusion coefficient (ADC) maps. Diffusion MRI was obtained by the spin-echo echo-planar imaging sequence (n=20 patients) or by the gradient-echo diffusion sequence, PSIF (n=4). In the PSIF sequence, pixel lens calculations were performed. In the echo-planar sequence, ADC value calculations were performed by using Stejskal-Tanner formula and by direct reading from automatically generated ADC maps. ADC values obtained from the normal appearing parenchyma were used as controls. Twenty patients with acute cerebral infarction were included for comparison of ADC values with those of iron deposition. The mean ADC value in the normal cerebral parenchyma was 0.85+/-0.11 x 10(-3) mm(2)/s. In the globus pallidus, mean ADC value was 48+/-0.12 x 10(-3) mm(2)/s. That of regions with acute infarction was 0.34+/-0.11 x 10(-3) mm(2)/s. On b=0 or 50, b=500 and b=1000 s/mm(2) images of the echo-planar diffusion imaging globus pallidus appeared hypointense compared to surrounding parenchymal structures. Low signal and low pixel values were evident on the PSIF imaging. This study indicates that, on diffusion MRI, normal iron deposition reveals prominent low signal on all the images of the echo-planar diffusion imaging sequence with differing b values, as well as on the gradient-echo diffusion, PSIF sequence. Low signal on ADC maps and low ADC values are evident. These represent characteristic diffusion MRI features of normal iron deposition in the brain, reflecting susceptibility effects.