Objective: We evaluated the signal intensity of the cerebral gyri (CG) on phase difference enhanced imaging (PADRE) for the patients with corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), and Parkinson’s disease (PD) to determine whether it is possible to discriminate among them on an individual basis.

Background: Typical MR findings in CBD are reliably found only in late disease. Therefore, from a neuroradiological point of view, differentiation between CBD from PD has traditionally proved challenging. PADRE is designed to select the phase difference between the object and surrounding tissue, and can enhance them selectively.¹ Contrast on PADRE images can reflect not only iron content but also myelin density.²

Methods: All studies were performed on a 3T MR imaging system. Axial PADRE images was obtained with a 3D multi-echo spoiled gradient echo sequence. First, two reviewers evaluated the difference between the CG appearance of the healthy subjects and abnormal CG appearance of CBD patients on PADRE in a non-blinded manner. Then, based on the CG abnormalities, two other reviewers reviewed PADRE images from 9 CBD patients, 9 PSP and 20 PD in a blinded manner. In addition, for the conventional MRI, two reviewers independently reviewed typical findings (disappearance of subcortical WM hypointensity and low signal intensity layer in superficial GM) of CBD which have been reported previously.

Results: Regarding CBD-specific findings on PADRE, the radiologists found hypointense layer in the superficial gray matter and disappearance of hypointense subcortical white matter (Figure). The frequency of this sign in the blinded manner was 100% (9/9) in CBD patients and 45% (5/11) in PSP, whereas 5% (1/20) in PD. The typical findings in CBD on conventional MRI were observed in only 44% (4/9) of CBD patients.

Conclusions: Our study on PADRE images presented novel findings in the gyrus of CBD patients, which might be useful to discriminate CBD from PD on an individual basis.

References: 1.           Haacke EM, Xu Y, Cheng YCN, Reichenbach JR. Susceptibility weighted imaging (SWI). Magnetic resonance in medicine 2004;52(3):612-618.

2.           Kakeda S, Yoneda T, Ide S, Watanabe K, Hiai Y, Korogi Y. Signal intensity of superficial white matter on phase difference enhanced imaging as a landmark of the perirolandic cortex. Acta Radiologica 2015:0284185115585162.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/signal-intensity-of-cerebral-gyri-in-corticobasal-degeneration-on-phase-difference-enhanced-mr-images-comparison-with-progressive-supranuclear-palsy-and-parkinsons-disease/