title: The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson's disease?
abstract: BACKGROUND
  The putaminal abnormalities detected on 1.5 T magnetic resonance imaging (MRI), such as putaminal atrophy, slit-like hyperintense rim, and hypointensity in the putamen on T2-weighted (T2W) imaging are important signs on differentiating multiple system atrophy with parkinsonism (MSA-P) from Parkinson's disease (PD). However, the putaminal abnormalities may have different manifestations on 3.0 T from those on 1.5 T.
  
  
  OBJECTIVE
  To investigate the diagnostic value of putaminal abnormalities on 3.0 T MRI for differentiating MSA-P from PD.
  
  
  METHODS
  The study included a MSA-P group (9 men, 9 women), a PD group (12 men, 14 women), and a control group (11 men, 13 women). All subjects were examined with 3.0 T MRI using the conventional protocol. Putaminal atrophy, T2-hypointensity in the dorsolateral putamenat, and a slit-like hyperintense rim on the lateral putamen were evaluated in each subject.
  
  
  RESULTS
  There were no significant differences in the slit-like hyperintense rim (P = 0.782) or T2-hypointensity in the dorsolateral putamen (P = 0.338) among the three groups. Bilateral putaminal atrophy was found in 44.4% (8 of 18) of the MSA-P patients, in only 7.7% (2 of 26) of the PD patients, and in none of the controls. The proportion of subjects with putaminal atrophy was significantly higher in the MAS-P group (P = 0.008) and control group (P < 0.001). The specificity and sensitivity of putaminal atrophy for distinguishing MSA-P from PD was 92.3% and 44.4%, respectively.
  
  
  CONCLUSIONS
  The signal changes in the putamen on T2W imaging on 3.0 T MRI, including slit-like hyperintense rim and putaminal hypointensity, are not specific signs for MSA-P. Putaminal atrophy is highly specific for differentiating MSA-P from PD and healthy controls, but its insufficient sensitivity limits its diagnostic value.
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
authors.forename: Jie-Ying
authors.initials: JY
authors.lastname: Feng
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China cjr.huangbiao@vip.163.com.
authors.forename: Biao
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
authors.forename: Wan-Qun
authors.initials: WQ
authors.lastname: Yang
authors.affiliation: Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
authors.forename: Yu-Hu
authors.initials: YH
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Wang
authors.affiliation: Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Zhong
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D019578:Multiple System Atrophy / Q000175:diagnosis*; D010300:Parkinson Disease / Q000175:diagnosis*; D020734:Parkinsonian Disorders / Q000175:diagnosis; D011699:Putamen / Q000002:abnormalities* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: CNS; brain/brain stem; efficacy studies; magnetic resonance imaging (MRI)