1
|
Prasuhn J, Neumann A, Strautz R, Dreischmeier S, Lemmer F, Hanssen H, Heldmann M, Schramm P, Brüggemann N. Clinical MR imaging in Parkinson's disease: How useful is the swallow tail sign? Brain Behav 2021; 11:e02202. [PMID: 34032020 PMCID: PMC8323030 DOI: 10.1002/brb3.2202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/01/2021] [Accepted: 05/11/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND With conventional MRI, no Parkinson's disease (PD)-specific abnormalities can be detected. However, there is a critical need for accompanying neuroimaging markers to guide the diagnosis. With high-resolution susceptibility-weighted MRI (SWI) sequences, the imaging of nigrosome-1 (N1) is possible. The so-called swallow tail sign (STS) has been proposed as a suitable neuroimaging marker for the diagnosis of PD. OBJECTIVES To investigate whether the absence of the STS can be applied for distinguishing PD patients from healthy controls (HCs). METHODS SWI images of 44 PD patients and 50 age- and gender-matched HCs were investigated using a 3T MRI scanner. Two trained neuroradiologists blind-rated the images and evaluated whether the STS was absent (1) on one side or (2) both sides of the participant's midbrain. RESULTS Our results confirmed good interrater reliability comparable to previously published studies. However, we did not identify any group differences between PD patients and HCs. Measures of diagnostic values revealed overall poor diagnostic performance. CONCLUSIONS Even though previously stated, our study does not confirm the potential use of the STS as a supportive neuroimaging marker for PD in a clinical setting. In conclusion, there is a critical need for improvements in N1-targeted MRI sequences and the development of advanced segmentation algorithms.
Collapse
Affiliation(s)
- Jannik Prasuhn
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany.,Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
| | - Alexander Neumann
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Robert Strautz
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Shalida Dreischmeier
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Felicitas Lemmer
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Henrike Hanssen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany.,Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
| | - Marcus Heldmann
- Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany.,Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany.,Institute of Psychology II, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Peter Schramm
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany.,Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
| |
Collapse
|
2
|
Bae YJ, Song YS, Kim JM, Choi BS, Nam Y, Choi JH, Lee WW, Kim JH. Determining the Degree of Dopaminergic Denervation Based on the Loss of Nigral Hyperintensity on SMWI in Parkinsonism. AJNR Am J Neuroradiol 2021; 42:681-687. [PMID: 33509919 DOI: 10.3174/ajnr.a6960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/21/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND PURPOSE Nigrostriatal dopaminergic function in patients with Parkinson disease can be assessed using 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropan dopamine transporter (123I-FP-CIT) SPECT, and a good correlation has been demonstrated between nigral status on SWI and dopaminergic denervation on 123I-FP-CIT SPECT. Here, we aim to correlate quantified dopamine transporter attenuation on 123I-FP-CIT SPECT with nigrosome-1 status using susceptibility map-weighted imaging (SMWI). MATERIALS AND METHODS Between May 2017 and January 2018, consecutive patients with idiopathic Parkinson disease (n = 109) and control participants (n = 29) who underwent 123I-FP-CIT SPECT with concurrent 3T SWI were included. SMWI was generated from SWI. Two neuroradiologists evaluated nigral hyperintensity from nigrosome-1 on each side of the substantia nigra. Using consensus reading, we compared the 123I-FP-CIT-specific binding ratio according to nigral hyperintensity status and the 123I-FP-CIT specific binding ratio threshold to confirm the loss of nigral hyperintensity was determined using receiver operating characteristic curve analysis. RESULTS The concordance rate between SMWI and 123I-FP-CIT SPECT was 65.9%. The 123I-FP-CIT-specific binding ratios in the striatum, caudate nucleus, and putamen were significantly lower when nigral hyperintensity in the ipsilateral substantia nigra was absent than when present (all, P < .001). The 123I-FP-CIT-specific binding ratio threshold values for the determination of nigral hyperintensity loss were 2.56 in the striatum (area under the curve, 0.890), 3.07 in the caudate nucleus (0.830), and 2.36 in the putamen (0.887). CONCLUSIONS Nigral hyperintensity on SMWI showed high positive predictive value and low negative predictive value with dopaminergic degeneration on 123I-FP-CIT SPECT. In patients with Parkinson disease, the loss of nigral hyperintensity is prominent in patients with lower striatal specific binding ratios.
Collapse
Affiliation(s)
- Y J Bae
- From the Department of Radiology (Y.J.B., B.S.C., J.H.K.)
| | - Y S Song
- Nuclear Medicine (Y.S.S., W.W.L.)
| | - J-M Kim
- Neurology (J.-M.K., J.-H.C.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - B S Choi
- From the Department of Radiology (Y.J.B., B.S.C., J.H.K.)
| | - Y Nam
- Division of Biomedical Engineering (Y.N.), Hankuk University of Foreign Studies, Gyeonggi-do, Republic of Korea
| | - J-H Choi
- Neurology (J.-M.K., J.-H.C.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - W W Lee
- Nuclear Medicine (Y.S.S., W.W.L.)
- Medical Research Center, Institute of Radiation Medicine (W.W.L.), Seoul National University, Seoul, Republic of Korea
| | - J H Kim
- From the Department of Radiology (Y.J.B., B.S.C., J.H.K.)
| |
Collapse
|
3
|
Sotoudeh H, Sarrami AH, Wang JX, Saadatpour Z, Razaei A, Gaddamanugu S, Choudhary G, Shafaat O, Singhal A. Susceptibility-Weighted Imaging in Neurodegenerative Disorders: A Review. J Neuroimaging 2021; 31:459-470. [PMID: 33624404 DOI: 10.1111/jon.12841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 01/01/2023] Open
Abstract
As human life expectancy increases, there is an increased prevalence of neurodegenerative disorders and dementia. There are many ongoing research trials for early diagnosis and management of dementia, and neuroimaging is a critical part of such studies. However, conventional neuroimaging often fails to provide enough diagnostic findings in patients with neurodegenerative disorders. In this context, different MRI sequences are currently under investigation to facilitate the accurate diagnosis of such disorders. Susceptibility-weighted imaging (SWI) is an innovative MRI technique that utilizes "magnitude" and "phase" images to produce an image contrast that is sensitive for the detection of susceptibility differences of the tissues. As many neurodegenerative disorders are associated with accelerated iron deposition and/or microhemorrhages in different parts of the brain, SWI can be applied to detect these diagnostic clues. For instance, in cerebral amyloid angiopathy, SWI can demonstrate cortical microhemorrhages, which are predominantly in the frontal and parietal regions. Or in Parkinson disease, abnormal swallow-tail sign on high-resolution SWI is highly diagnostic. Also, SWI is a useful sequence to detect the low signal intensity of precentral cortices in patients with amyotrophic lateral sclerosis. Being familiar with SWI findings in neurodegenerative disorders is critical for an accurate diagnosis. In this paper, the authors review the technical parameters of SWI, physiologic, and pathologic iron deposition in the brain, and the role of SWI in the evaluation of neurodegenerative disorders in daily practice.
Collapse
Affiliation(s)
- Houman Sotoudeh
- Department of Radiology and Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL
| | | | - Jian-Xiong Wang
- Division of Physics and Engineering, University of Alabama at Birmingham (UAB), Birmingham, AL
| | - Zahra Saadatpour
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, AL
| | - Ali Razaei
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, AL
| | - Siddhartha Gaddamanugu
- Department of Radiology, University of Alabama at Birmingham (UAB) and VA Hospital, Birmingham, AL
| | - Gagandeep Choudhary
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, AL
| | - Omid Shafaat
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Aparna Singhal
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, AL
| |
Collapse
|