title: Loss of Nigral Hyperintensity on 3 Tesla MRI of Parkinsonism: Comparison With (123) I-FP-CIT SPECT.
abstract: The aim of this study was to investigate whether 3 Tesla susceptibility-weighted imaging can detect the alteration of substantia nigra hyperintensity in Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) and to assess the concordance between the loss of nigral hyperintensity on 3 Tesla susceptibility-weighted imaging and the nigrostriatal dopaminergic degeneration indicated by (123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computerized tomography.
  
  
  
  Consecutive subjects with suspected parkinsonism were included, and clinical diagnosis was solidified during clinical follow-up. Two blinded neuroradiologists interpreted the nigral hyperintensity on susceptibility-weighted imaging. The performance of susceptibility-weighted imaging for detection of nigral hyperintensity loss was estimated on the basis of the clinical diagnosis and compared with single photon emission computerized tomography results.
  
  
  
  The study included 210 subjects (126 PD, 11 MSA, 11 PSP patients, 26 healthy controls, 36 disease controls). The presence or absence of nigral hyperintensity was accurately visualized in 112 PD, 7 MSA, and 11 PSP patients and 53 controls. We identified 16 false-negative cases and 11 false-positive cases. The sensitivity and specificity of susceptibility-weighted imaging were 88.8% and 83.6%, respectively. The concordance rate between susceptibility-weighted imaging and single photon emission computerized tomography was 86.2%.
  
  
  
  The loss of nigral hyperintensity on susceptibility-weighted imaging suggested nigrostriatal dopaminergic degeneration in a large portion of patients with parkinsonism, which was indicated by (123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computerized tomography. In consideration of false-negative and -positive cases, well-designed imaging protocols should be introduced to improve the performance of nigral hyperintensity imaging. © 2016 International Parkinson and Movement Disorder Society.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Bae
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.|Department of Radiology, Kyung Hee University Hospital, Seoul, Korea.
authors.forename: Kyung Mi
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Kang
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Kyeong Joon
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Eung Seok
authors.initials: ES
authors.lastname: Oh
authors.affiliation: Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Yun
authors.affiliation: Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea.
authors.forename: Ji Seon
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Hye-Jin
authors.initials: HJ
authors.lastname: Jeong
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Jeon
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.|Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging*; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D013378:Substantia Nigra / Q000000981:diagnostic imaging*; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards*
keywords: Parkinson's disease; magnetic resonance imaging; multiple system atrophy; progressive supranuclear palsy