title: Thin section MR study of the basal ganglia in the differential diagnosis between striatonigral degeneration and Parkinson disease.
abstract: OBJECTIVE
  Signal abnormalities within the putamen in MRI have been related to tissue degeneration in the striatonigral variant of multiple system atrophy (MSA-P). While previous work demonstrated the high specificity of these MR findings, sensitivity rates were unsatisfactory. We evaluated the specificity and sensitivity of an acquisition protocol using thin section MRI to differentiate MSA-P from Parkinson disease (PD).
  
  
  METHODS
  Axial 3-mm-thick conventional T2 and proton density spin echo images at the level of basal ganglia were acquired at 1.5 T in 24 patients with MSA-P and 27 patients with PD.
  
  
  RESULTS
  We found an abnormal putaminal T2 hypointensity in 21 of 24 MSA-P patients (87.5% sensitivity) and a proton density hyperintensity in 20 of 24 MSA-P patients (83.3% sensitivity). Three among 27 PD patients had an abnormal putaminal T2 hypointensity (88.8% specificity) and there were no proton density abnormalities (100% specificity).
  
  
  CONCLUSIONS
  Our thin section conventional spin echo protocol showed a substantial increase in MR sensitivity compared with previous reports. We believe that a better depiction of even mild signs of degeneration in the putamen may allow a more widespread use of this technique in the differential diagnosis of parkinsonisms.
authors.affiliation: Radiology and Neuroradiology Service, Hospital V. Buzzi, Milan, Italy. neurorad@icp.mi.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Righini
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Massimo
authors.initials: M
authors.lastname: Ferrarini
authors.forename: Roberta
authors.initials: R
authors.lastname: de Notaris
authors.forename: Margherita
authors.initials: M
authors.lastname: Canesi
authors.forename: Fabio
authors.initials: F
authors.lastname: Triulzi
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
mesh_terms: D000368:Aged; D001479:Basal Ganglia / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000473:pathology*; D012680:Sensitivity and Specificity; D020955:Striatonigral Degeneration / Q000175:diagnosis / Q000473:pathology*