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Focal high signal on MR scans of the midbrain caused by enlarged perivascular spaces: MR-pathologic correlation

A D Elster1, D N Richardson

  • 1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.

AJR. American Journal of Roentgenology
|January 1, 1991
PubMed

Insights

High-resolution MRI revealed punctate and linear foci in the midbrain of 20% of patients. These abnormalities, near the substantia nigra, are likely enlarged perivascular spaces around penetrating arteries.

Area of Science:

  • Neuroimaging
  • Neuroanatomy

Background:

  • High-resolution Magnetic Resonance Imaging (MRI) is crucial for visualizing brainstem structures.
  • The substantia nigra is a key area affected in various neurological disorders.

Purpose of the Study:

  • To investigate the nature and origin of punctate and linear foci observed near the substantia nigra on brainstem MRI.
  • To correlate imaging findings with anatomical structures.

Main Methods:

  • High-resolution MRI of the brainstem was performed on 157 patients.
  • Lesion characteristics (signal intensity, location, laterality) were analyzed.
  • Anatomical specimens were reviewed to identify relevant vascular structures.

Main Results:

  • Abnormal signal foci were detected in 32 (20%) patients, predominantly near the substantia nigra and cerebral peduncle.
  • Lesions were best visualized on long TR/long TE sequences, appearing as high-intensity signals.
  • Anatomical review revealed penetrating arteries in this region, frequently associated with enlarged perivascular spaces.

Conclusions:

  • The observed punctate and linear foci on midbrain MRI are likely manifestations of enlarged perivascular spaces.
  • These findings are associated with penetrating branches of the collicular or accessory collicular arteries near the substantia nigra.

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