Hyperintense Putaminal Rim at 3T Reflects Fewer Ferritin Deposits in the Lateral Marginal Area of the Putamen
S. Fujiia,
E. Matsusuea,
T. Kinoshitaa,
S. Sugiharaa,
E. Ohamab and
T. Ogawaa
a Division of Radiology, Department of Pathophysiological and Therapeutic Science, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
b Department of Neuropathology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
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Fig 1. Classification of HPR on axial T2-weighted FSE images. A, Absent (15 years old). B, Vague (29 years old). C, Present (54 years old). D, Vague with marked and diffuse putaminal hypointenisty (77 years old).
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Fig 2. Frequency of HPR in 8 age groups. HPR becomes gradually prominent after 20 years of age and tends to become vague or absent after 70 years of age.
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Fig 3. Comparison of postmortem MR images and histologic findings in a 12-year-old subject. Postmortem axial (A) and coronal (B) T2-weighted images. A section corresponding to B stained with Klüver-Barrera (C), Berlin blue (D), and ferritin immunohistochemistry (E). Postmortem MR images (A and B) show absent HPR. With Klüver-Barrera staining (C), myelinated fibers are small in number in the lateral marginal area of the putamen (dotted lines) in comparison with the remainder. With Berlin blue staining, hemosiderin is scattered in the inner portion of the putamen but is scarce in the outer portion (D). With ferritin immunohistochemistry, ferritin deposits are mild in the inner portion but are scarce in the lateral marginal area of the putamen (dotted lines, E).
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Fig 4. Comparison of postmortem MR images and histologic findings in a 63-year-old subject. Postmortem axial (A) and coronal (B) T2-weighted images. Sections corresponding to B are stained with Klüver-Barrera (C), Berlin blue (D), and ferritin immunohistochemistry (E). Postmortem MR images (A and B) show present HPR. With Klüver-Barrera staining (C), HPR on a T2-weighed FSE image corresponds to the lateral marginal area of the putamen (dotted lines), where myelinated fibers are small in number in comparison with the remainder of the putamen. With Berlin blue staining (D), hemosiderin-stained blue is scattered in the inner portion of the putamen but is scarce in the lateral marginal area. With ferritin immunohistochemistry (E), ferritin deposits are mild in the lateral marginal area of the putamen (dotted lines), corresponding to HPR on the postmortem MR images (B). By contrast, the deposits are increased in the remainder of the putamen corresponding to the area of decreased signal intensity on the postmortem MR images (B).
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Fig 5. Comparison of postmortem MR images and histologic findings in an 83-year-old subject. Postmortem axial (A) and coronal (B) T2-weighted images. A section corresponding to B stained with Klüver-Barrera (C), Berlin blue (D), and ferritin immunohistochemistry (E). A and B, Postmortem MR images show diffuse putaminal hypointensity, and HPR is not detectable. With Klüver-Barrera staining (C), myelinated fibers are few in the lateral marginal area of the putamen (dotted lines). With Berlin blue staining (D), hemosiderin is scattered in the inner portion of the putamen but is scarce in the outer portion. Ferritin immunohistochemistry reveals diffuse ferritin deposits in the putamen, including the lateral marginal area (E).
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