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Putaminal lesion in multiple system atrophy: postmortem MR-pathological correlations.

Eiji Matsusue1, Shinya Fujii, Yoshiko Kanasaki

  • 1Department of Pathophysiological and Therapeutic Science, Division of Radiology, Faculty of Medicine, Tottori University, Yonago, Tottori Prefecture, Japan. matsusue@grape.med.tottori-u.ac.jp

Neuroradiology
|May 9, 2008
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Summary
This summary is machine-generated.

Putaminal changes in multiple system atrophy (MSA) with parkinsonism include atrophy and signal alterations. These MRI findings correlate with specific histological changes, aiding in diagnosis.

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Area of Science:

  • Neuroimaging
  • Neuropathology
  • Magnetic Resonance Imaging (MRI)

Background:

  • Posterior putaminal atrophy and T2 signal changes are observed in multiple system atrophy (MSA) with parkinsonism.
  • Understanding the MRI-histological correlation is crucial for diagnosing MSA.

Purpose of the Study:

  • To compare postmortem T2-weighted MRI findings with histological features in autopsy-proven MSA putaminal lesions.
  • To characterize the relationship between MRI signal intensities and pathological changes in the putamen.

Main Methods:

  • Postmortem T2-weighted MRI (1.5T and 3T) was performed on seven autopsy-proven MSA cases.
  • MRI findings were correlated with detailed histological examination of putaminal lesions.

Main Results:

  • Three types of putaminal changes were identified: Type 1 (atrophy, isointensity), Type 2 (atrophy, hyperintensity with hyperintense putaminal rim - HPR), and Type 3 (atrophy, iso/hypointensity with HPR).
  • Signal intensities varied with MRI field strength (3T vs 1.5T).
  • Histology revealed neuronal loss, gliosis, ferritin, and Fe(3+) deposition, with myelin loss and tissue rarefaction in the HPR.

Conclusions:

  • Posterior putaminal atrophy on MRI signifies neuronal loss and gliosis.
  • Putaminal signal changes reflect ferritin/Fe(3+) deposition (iso/hypointensity) or tissue rarefaction (hyperintensity).
  • The HPR indicates degeneration of the putaminal lateral margin and/or external capsule, characteristic of MSA with parkinsonism.