TY - JOUR T1 - Putaminal Hyperintensity on T1-Weighted MR Imaging in Patients with the Parkinson Variant of Multiple System Atrophy JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 689 LP - 692 DO - 10.3174/ajnr.A1443 VL - 30 IS - 4 AU - S. Ito AU - W. Shirai AU - T. Hattori Y1 - 2009/04/01 UR - http://www.ajnr.org/content/30/4/689.abstract N2 - BACKGROUND AND PURPOSE: A hyperintense putaminal rim, putaminal hypointensity, and putaminal atrophy on T2-weighted MR images are findings suggestive of parkinsonian-dominant multiple system atrophy (MSA-P). However, putaminal hyperintensity on T1-weighted images, which has not been discussed in previous reports, is also frequently observed in patients with MSA-P. Here, we investigated whether putaminal hyperintensity on T1-weighted images is helpful to diagnose MSA-P.MATERIALS AND METHODS: Patients with MSA-P (n = 17), Parkinson disease (PD; n = 37) and progressive supranuclear palsy (PSP; n = 11), and healthy control subjects (n = 16) were enrolled in this study. Two examiners, who were blind to the diagnoses, independently rated the putaminal hyperintensity on T1-weighted images (T1H), hyperintense putaminal rim on T2-weighted images (T2H), putaminal hypointensity on T2-weighted images (T2 L), and putaminal atrophy by using a visual analog scale, and performed a receiver operating characteristic (ROC) analysis. The area under the curve (AUC; minimum, 0.5; maximum, 1.0) was automatically calculated as a positive parameter, indicating its usefulness to differentiate between diseases.RESULTS: For differentiating patients with MSA-P from healthy control subjects, AUC values were 0.983 for T1H, 0.923 for T2H, 0.726 for T2 L, and 0.967 for putaminal atrophy. Between MSA-P and PD, the respective AUC values were 0.990, 0.921, 0.739, and 0.923; and between MSA-P and PSP, the respective AUC values were 0.984, 0.923, 0.727, and 0.967.CONCLUSIONS: All putaminal findings except T2 L were useful for the diagnosis of MSA-P. T1H was superior to T2H to differentiate MSA-P from other diseases. ER -