title: Zebra sign of precentral gyri in amyotrophic lateral sclerosis: A novel finding using phase difference enhanced (PADRE) imaging-initial results.
abstract: OBJECTIVE
  We compared the precentral gyri (PG) on the PADRE of patients with amyotrophic lateral sclerosis (ALS) and healthy subjects (HSs) in order to determine whether it is possible to discriminate between ALS patients and HSs on an individual basis.
  
  
  METHODS
  First, two radiologists reviewed the appearance of the normal PG and that of ALS patients on PADRE in a non-blinded manner, and deviations from the appearance of the normal PG were recorded. Next, based on the presence of PG abnormalities on PADRE, we performed an observer performance study using 16 ALS patients and 16 HSs.
  
  
  RESULTS
  The radiologists were able to consensually define the PG as abnormal on PADRE when a low-signal-intensity layer was observed in the gray matter of the PG; a three- or four-layer organization (zebra sign) was characterized by the low-signal-intensity layer. The observer performance study demonstrated that the sensitivity, specificity, and accuracy of PG abnormalities on PADRE for discriminating ALS patients from HSs were 94 %, 94 %, and 94 %, respectively, for reviewers 1 and 2.
  
  
  CONCLUSIONS
  It was possible to discriminate between ALS patients and HSs based on the presence of PG abnormalities on PADRE, which may reflect upper motor neuron impairment in ALS.
  
  
  CONCLUSIONS
  • PADRE reveals low-signal-intensity layer in the PG of ALS • By PADRE findings on PG, we can discriminate ALS from HSs • PADRE may be a useful method for detecting UMN impairment in ALS.
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. kakeda@med.uoeh-u.ac.jp.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kakeda
authors.affiliation: Department of Medical Physics in Advanced Biomedical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yoneda
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ide
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Miyata
authors.affiliation: Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Futatsuya
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogasawara
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Moriya
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Okada
authors.affiliation: Department of Neurology, Wakamatsu Hospital of the University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Uozumi
authors.affiliation: Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000000981:diagnostic imaging*; D000818:Animals; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging*; D066128:Gray Matter / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Amyotrophic lateral sclerosis; MRI; Motor cortex; Precentral gyrus; Superficial white matter
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