title: Dorsolateral nigral hyperintensity on 3.0T susceptibility-weighted imaging in neurodegenerative Parkinsonism.
abstract: BACKGROUND
  Absence of a hyperintense, ovoid area within the dorsolateral border of the otherwise hypointense pars compacta of the substantia nigra (referred to as dorsolateral nigral hyperintensity) on iron-sensitive high-field magnetic resonance imaging sequences seems to be a typical finding for patients with Parkinson's disease (PD).
  
  
  OBJECTIVE
  This study was undertaken to evaluate the diagnostic value of the dorsolateral nigral hyperintensity in a cohort of patients with neurodegenerative parkinsonism including PD, multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) as well as healthy controls using high-field susceptibility-weighted imaging (SWI) at 3.0 Tesla (T).
  
  
  METHODS
  Absence of dorsolateral nigral hyperintensity was assessed on visual inspection of anonymized 3.0T SWI scans in a case-control study including 148 patients with neurodegenerative parkinsonism (PD: n = 104; MSA: n = 22; PSP: n = 22) and 42 healthy controls.
  
  
  RESULTS
  Dorsolateral nigral hyperintensity was absent unilaterally in all patients with MSA or PSP, in 83 of 90 patients with PD, but only in one of the healthy controls resulting in an overall correct classification of 95.2% in discriminating neurodegenerative parkinsonism from controls in the per-protocol analysis. Overall correct classification was 93.2% in the intent-to-diagnose analysis, including also SWI scans with poor quality (12.1% of all scans) for nigral evaluation.
  
  
  CONCLUSIONS
  Visual assessment of dorsolateral nigral hyperintensity on high-field SWI scans may serve as a new simple diagnostic imaging marker for neurodegenerative parkinsonian disorders.
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Reiter
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Mueller
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Pinter
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Krismer
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.|Neuroimaging Research Core Facility, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Scherfler
authors.affiliation: Department of Radiology I, Innsbruck Medical University, Innsbruck, Austria.|Neuroimaging Research Core Facility, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Regina
authors.initials: R
authors.lastname: Esterhammer
authors.affiliation: Department of Radiology I, Innsbruck Medical University, Innsbruck, Austria.|Neuroimaging Research Core Facility, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Kremser
authors.affiliation: Department of Radiology I, Innsbruck Medical University, Innsbruck, Austria.|Neuroimaging Research Core Facility, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Schocke
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Gregor K
authors.initials: GK
authors.lastname: Wenning
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.|Neuroimaging Research Core Facility, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.|Neuroimaging Research Core Facility, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
mesh_terms: D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000473:pathology*; D010300:Parkinson Disease / Q000473:pathology*; D012680:Sensitivity and Specificity; D013378:Substantia Nigra / Q000473:pathology*; D013494:Supranuclear Palsy, Progressive / Q000473:pathology*
chemical_list: D015415:Biomarkers
keywords: Parkinson's disease; dorsolateral nigral hyperintensity; multiple system atrophy; progressive supranuclear palsy; substantia nigra