Dorsolateral Nigral Hyperintensity On 3.0T SWI In Parkinson's Disease And Vascular Parkinsonism

BackgroundParkinson's disease(PD)is the second most common neurodegenerative disease in the nervous system.Standard neuroimaging fails in defining the anatomy of the substantia nigra and has a marginal role in the diagnosis of Parkinson disease.In recent years,7 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).Further studies have found that 3T susceptibility-weighted imaging can also detect abnormal signals of intracranial substantia nigra dorsolateral in Parkinson's disease patients.ObjectiveThe aim of this study was to investigate whether 3 Tesla susceptibility-weighted imaging(SWI)can visualize anatomical alterations occurring in a hyperintense structure of the substantia nigra in Parkinson's disease(PD)and vascular parkinsonism(VP),and whether the evaluation of abnormal signal can be used as a factor in the differential diagnosis of PD and VP.MethodsThirty-eight healthy subjects,Thirty-three patients with Parkinson's disease and Thirty-four patients with vascular parkinsonism underwent MR imaging examination at 3T.Their ender,age,course of disease,initial symptoms were recorded,and the disease was graded according to Hoehn-Yahr stages.Two neuroimaging experts evaluated the images,independently.The sensitivity,specificity and positive predictive value of susceptibility-weighted imaging in the diagnosis of PD and VP were calculated,respectively.ResultsThe susceptibility-weighted imaging images of 109 patients in the experimental group and the control group were evaluated.The image quality of 4 patients had serious artifacts,which were removed from the data.Among the remaining 105 cases,31 of the 33 PD patients had no dorsal lateral substantia nigra hyperintensity and 2 of the advanced PD patients had dorsal lateral substantia nigra hyperintensity;of the 34 VP patients,15 had no dorsal lateral substantia nigra hyperintensityl and 19 had dorsal lateral substantia nigra hyperintensity;of 38 healthy controls,35 had dorsal lateral substantia nigra hyperintensity and 3 had no dorsal lateral substantia hyperintensity.The sensitivities of susceptibility-weighted imaging for PD and VP were 93.9% and 44.1%,and the specificities were 92.1% and 92.1%,respectively.3T SWI had a highly sensitive to the diagnosis of PD,and was significantly higher than that of VP.ConclusionsVisual assessment of dorsolateral nigral hyperintensity on high-field SWI scans may serve as a new and simple visual diagnostic imaging marker for PD.And it may be used as a tool for differentiating Parkinson's disease from vascular parkinsonism,which will promote the application of 3T SWI technique in clinical practice.