title: Decreased T1 contrast between gray matter and normal-appearing white matter in CADASIL.
abstract: OBJECTIVE
  CADASIL is the most frequent hereditary small-vessel disease of the brain. The clinical impact of various MR imaging markers has been repeatedly studied in this disorder, but alterations of contrast between gray matter and normal-appearing white matter remain unknown. The aim of this study was to evaluate the contrast alterations between gray matter and normal-appearing white matter on T1-weighted images in patients with CADASIL compared with healthy subjects.
  
  
  METHODS
  Contrast between gray matter and normal-appearing white matter was assessed by using histogram analyses of 3D T1 high-resolution MR imaging in 23 patients with CADASIL at the initial stage of the disease (Mini-Mental State Examination score > 24 and modified Rankin scale score ≤ 1; mean age, 53.5 ± 11.1 years) and 30 age- and sex-matched controls.
  
  
  RESULTS
  T1 contrast between gray matter and normal-appearing white matter was significantly reduced in patients compared with age- and sex-matched controls (patients: 1.35 ± 0.08 versus controls: 1.43 ± 0.04, P < 10(-5)). This reduction was mainly driven by a signal decrease in normal-appearing white matter. Contrast loss was strongly related to the volume of white matter hyperintensities.
  
  
  CONCLUSIONS
  Conventional 3D T1 imaging shows significant loss of contrast between gray matter and normal-appearing white matter in CADASIL. This probably reflects tissue changes in normal-appearing white matter outside signal abnormalities on T2 or FLAIR sequences. These contrast alterations should be taken into account for image interpretation and postprocessing.
authors.affiliation: From University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: De Guio
authors.forename: S
authors.initials: S
authors.lastname: Reyes
authors.forename: M
authors.initials: M
authors.lastname: Duering
authors.forename: L
authors.initials: L
authors.lastname: Pirpamer
authors.forename: H
authors.initials: H
authors.lastname: Chabriat
authors.forename: E
authors.initials: E
authors.lastname: Jouvent
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D046589:CADASIL / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009474:Neurons / Q000473:pathology*