Hyperintense Putaminal Rim Sign Is Not a Hallmark of Multiple System Atrophy at 3T
Wei-Hsing Leea,
Chau-Chin Leea,
Woei-Cherng Shyub,
Pau-Nyen Chonga and
Shinn-Zong Linc
a Department of Radiology, Neuro-Medical Scientific Center, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, Republic of China
b Department of Neurology, Neuro-Medical Scientific Center, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, Republic of China
c Department of Neurosurgery, Neuro-Medical Scientific Center, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, Republic of China
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FIG 1. Concomitant axial T2-weighted imaging (TR, 4000 ms; TE, 105 ms) (A) and FLAIR imaging (TR, 6902 ms; TE, 90 ms; TI, 2100 ms) (B) of a healthy 46-year-old woman (case 10) are performed at the striatal level on the 3T scanner; (C) equivalent T2-weighted image (TR, 4400 ms; TE, 95 ms) is acquired at 1.5T.
A, There are bilateral slitlike signal intensity changes (grade 1 on right side and grade 2 on left side), consisting of a lateral hyperintense rim at the lateral border of the putamen (HPR) and a grade 1 hypointense area medial to this rim.
B, FLAIR image demonstrates vague hyperintensities of the putaminal outer margin.
C, The hyperintense rim is absent on T2-weighted image at 1.5T. Note grade 0 putaminal signal intensity hypointensity relative to the globus pallidus.
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FIG 2. Brain MR imaging of a healthy 46-year-old woman (case 3) uses the same scanning protocol as that of Fig 1.
A, There are grade 2 HPRs on the right and grade 3 on the left and grade 2 dorsolateral putaminal hypointensities.
B, FLAIR image demonstrates grade 1 HPR on left side only.
C, Signal intensity changes of bilateral HPR in A turn to negative findings. The dorsolateral putaminal hypointensities become brighter signals than those in A.
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