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Utility of the fluid-attenuated inversion recovery sequence in detecting a hyperintense putaminal rim in multiple
Keita Sakurai1, Takemori Yamawaki, Kenji Okita
1Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Nagoya, Japan. ksak666@yahoo.co.jp
Objective:
To investigate the utility of fluid-attenuated inversion recovery (FLAIR) imaging for diagnosing multiple system atrophy-parkinsonism (MSA-P).
Methods:
We retrospectively evaluated 49 subjects (19 with MSA-P including 11 with early-stage disease, 15 with Parkinson's disease and 15 matched controls) in order to compare the diagnostic value of FLAIR imaging to detect a hyperintense putaminal rim (HPR) with that of T(2)-weighted (T2W) imaging.
Results:
Compared with T2W imaging, FLAIR imaging detected HPR more conspicuously in the 19 MSA-P patients (p = 0.01); this trend was also observed in 11 early-stage MSA-P patients (p = 0.01). Furthermore, FLAIR imaging tended to increase sensitivity of detecting HPR compared with T2W imaging (all patients: 89 vs. 58%, p = 0.07; early-stage patients: 100 vs. 55%, p = 0.06).
Conclusions:
FLAIR imaging might be more useful for detecting HPR in MSA-P patients, even though they are at an early stage.
Insights
Fluid-attenuated inversion recovery (FLAIR) MRI is more effective than T2-weighted (T2W) MRI for detecting the hyperintense putaminal rim (HPR) in multiple system atrophy-parkinsonism (MSA-P). This improved detection holds true even for early-stage MSA-P patients.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Multiple system atrophy-parkinsonism (MSA-P) is a neurodegenerative disorder.
- Accurate diagnosis is crucial for patient management.
- Identifying specific imaging biomarkers can aid in early diagnosis.
Purpose of the Study:
- To evaluate the diagnostic utility of fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) for detecting the hyperintense putaminal rim (HPR).
- To compare the effectiveness of FLAIR imaging against T2-weighted (T2W) imaging in identifying HPR in patients with MSA-P.
Main Methods:
- Retrospective analysis of 49 subjects: 19 with MSA-P (11 early-stage), 15 with Parkinson's disease, and 15 controls.
- Comparison of HPR detection rates between FLAIR and T2W imaging.
- Statistical analysis to determine the significance of observed differences.
Main Results:
- FLAIR imaging detected HPR more conspicuously in MSA-P patients compared to T2W imaging (p = 0.01).
- This enhanced detection was also significant in early-stage MSA-P patients (p = 0.01).
- FLAIR imaging showed a trend towards increased sensitivity for HPR detection (89% vs. 58% overall, 100% vs. 55% in early-stage).
Conclusions:
- FLAIR imaging demonstrates superior utility in detecting HPR in patients with MSA-P.
- The diagnostic advantage of FLAIR is evident even in the early stages of the disease.
- FLAIR MRI may serve as a valuable tool for improving the diagnosis of MSA-P.
