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Reduced signal intensity on MR images of thalamus and putamen in multiple sclerosis: increased iron content?
Abstract:
High-field-strength (1.5-T) MR imaging was used to evaluate 47 patients with definite multiple sclerosis and 42 neurologically normal control patients. Abnormal, multiple foci of increased signal intensity on T2-weighted images, most prominent in the periventricular white matter, were apparent in 43 of 47 MS patients and in two of 42 control patients. A previously undescribed finding of relatively decreased signal intensity most evident in the putamen and thalamus on T2-weighted images was seen in 25 of 42 MS patients and correlated with the degree of white-matter abnormality. In the normal control patients a prominently decreased signal intensity was noted in the globus pallidus, as compared with the putamen or thalamus, correlating closely with the distribution of ferric iron as determined in normal Perls'-stained autopsy brains. The decreased signal intensity (decreased T2) is due to ferritin, which causes local magnetic field inhomogeneities and is proportional to the square of the field strength. The decreased T2 in the thalamus and striatum in MS may be related to abnormally increased iron accumulation in these locales with the underlying mechanism remaining speculative.
Insights
Magnetic Resonance Imaging (MRI) revealed distinct white matter abnormalities in multiple sclerosis (MS) patients. A novel finding showed decreased signal intensity in specific brain regions, potentially linked to iron accumulation in MS.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease characterized by demyelination and axonal damage.
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing and monitoring MS, particularly T2-weighted sequences for detecting white matter lesions.
Purpose of the Study:
- To evaluate the utility of high-field-strength (1.5-T) MRI in characterizing brain abnormalities in patients with definite multiple sclerosis.
- To identify and describe novel MRI findings in MS patients, specifically focusing on signal intensity changes in deep gray matter structures.
Main Methods:
- Utilized 1.5-Tesla (T) MRI to image 47 patients with definite MS and 42 neurologically normal controls.
- Analyzed T2-weighted images to identify and quantify signal intensity abnormalities in white matter and deep gray matter structures.
Main Results:
- 43 of 47 MS patients exhibited abnormal, multiple foci of increased signal intensity in T2-weighted images, predominantly in periventricular white matter.
- A novel finding of decreased signal intensity on T2-weighted images was observed in the putamen and thalamus of 25 of 42 MS patients, correlating with white matter abnormalities.
- Normal controls showed decreased signal intensity in the globus pallidus, consistent with normal iron distribution.
Conclusions:
- High-field-strength MRI effectively detects white matter lesions in MS.
- Decreased T2 signal intensity in the thalamus and striatum of MS patients may indicate abnormal iron accumulation, warranting further investigation into its underlying mechanisms and clinical significance.