[en] We retrospectively studied magnetic resonance images of the brain in 158 patients (8 cases of amyotrophic lateral sclerosis, 16 cases of Alzheimer's disease, 8 cases of Parkinson's disease, 53 cases of multiple cerebral infarct, 20 cases of other central nervous system (CNS) diseases, and 53 cases without any CNS disease) to examine the appearance of T2-weighted low signal intensity areas (LIA) in the cerebral cortex. The age of subjects ranged from 36 to 85 years with the mean 65.0 and SD 9.9 years. LIA in the motor and sensory cortices, and brain atrophy were evaluated visually on axial images of the spin-echo sequence obtained with a 1.5 tesla system. The incidence of LIA in the motor cortex was significantly higher in all CNS diseases than in cases without any CNS disease, but not significantly different among CNS diseases. LIA in the motor cortex showed a correlation with age, temporal and parietal atrophy. The appearance of LIA in the sensory cortex correlated with that of LIA in the motor cortex, and parietal atrophy. These results suggest that LIA may appear according to age and be associated with the accumulation of nonheme iron in the cortex, especially in patients with CNS diseases. (author)

[en] We compared atrophy and magnetization transfer ratio (MTR) in the corpus callosum in patients with Alzheimer's disease and age-matched normal subjects. Fifteen patients with Alzheimer's disease and fourteen normal subjects received MRI. The corpus callosum was divided into three parts (anterior, middle, and posterior portions) on midsagittal slice, and their areas on T2-weighted reversed images and MTR on magnetization transfer contrast images in each portion were measured. The area and MTR decreased significantly in the posterior portion in patients with Alzheimer's disease. In the anterior portion, MTR decreased significantly, but although the area showed no significant change. In the middle portion, the area and MTR showed no significant change. MTR and the area was correlated in each portion in patients with Alzheimer's disease. The score of Hasegawa dementia scale-revised (HDS-R) and the area of the middle, posterior and total of corpus callosum were significantly related. The score of HDS-R and MTR in the anterior portion of corpus callosum were significantly related. The present study revealed decreases in MTR in the anterior portion of the corpus callosum of patients with Alzheimer's disease although the area showed no significant change, and this change suggests the increase in free water and/or the decrease in bound water in tissues, probably due to demyelination and axonal degeneration. (author)

[en] Using magnetization transfer (MT) imaging, we studied the underlying pathological conditions of periventricular hyperintense (PVH) white matter changes seen on T2-weighted MR images of patients with multi-infarct dementia. Twenty-two patients with multiple lacunar infarcts and PVH lesions, including 11 with dementia (diagnosed as multi-infarct dementia) and 11 without dementia, and 10 control subjects (with multiple lacunes, but no PVH lesion) were studied using the MT technique. MT ratios (MTRs) were calculated for PVH lesions (normal-appearing frontal white matter in controls) and the genu of the corpus callosum. Signal intensities on T2-weighted images in PVH lesions of patients were significantly higher than those in normal-appearing white matter of controls, while there were no significant differences in signal intensity in the genu of the corpus callosum among the dementia, non-dementia and control groups. However, MTRs in patients with PVH lesions were significantly lower than those in controls, and MTRs in demented patients were significantly lower than those in non-demented patients. Moreover, MTRs in the genu of the corpus callosum of demented patients were significantly lower than in those in non-demented patients and controls. MTRs in PVH lesions and the genu of the corpus callosum significantly correlated with Hasegawa's dementia scale score. These results suggest that there is some difference in histopathologic changes of PVH lesions between demented and non-demented patients and that the pathological substrate in the corpus callosum may play a role in inducing cognitive decline. Studies with MT imaging may allow the characterization of different pathological conditions that cannot be visualized by conventional MRI. (author)

[en] Magnetization transfer (MT) contrast images of the brain were obtained in 17 patients (30 studies) with supratentorial cerebral infarction, and the changes in MT effects (Moff-Mon/Moff) expressed as the ratio of lesion to control (L/C ratio) were assessed over time. Acute infarct lesions could not be detected or were relatively slight on the MT contrast images. However, subacute and chronic infarcts were shown with a low signal intensity, and the L/C ratios at these periods were significantly lower than those in at the acute stage. A significant correlation was noted between the L/C ratio and days after onset of stroke. MT contrast imaging is useful in the assessment of ischemic stroke, particularly at the subacute and chronic stages, and can assist in determining the age of cerebral infarcts. (author)

[en] We reported previously that Low T₂ intensity areas (LIAs) are more common in patients with central nervous system (CNS) diseases than in those with no such diseases, and that the occurrence of LIAs increases with aging. To determine a relationship between the intensity changes and aging, we investigated the intensity of the cerebral cortex in 26 normal Japanese individuals. Measurements of brain MRIs were performed with a Signa Advantage apparatus at 1.5 tesla. T₂-weighted images were obtained using the spin-echo pulse sequences. On our laboratory console, we measured signal intensities in the regions of interest in the prefrontal, motor, sensory, parietal, temporal, or occipital cortex, and in the frontal white matter. To remove the effect of the system gain settings on signal intensity, that of cerebrospinal fluid was used as reference according to the method of Pujol et al. The average intensity in the temporal and prefrontal cortices was the highest, followed in order by the parietal, sensory, motor, and occipital cortices. The intensity in the temporal and parietal cortices decreased significantly with aging, and that in the motor and sensory cortices had a tendency to decrease with aging. The intensity in the motor and sensory cortices of the elderly subjects and that in the occipital cortex throughout all ages were lower than that in the prefrontal white matter, which would result in the appearance of LIAs. The average intensity of each cerebral cortex was inversely related to the non-heme iron content previously reported. It is likely that the difference in intensity among the cortices reflects variations of the non-heme iron content, and that the change in intensity with aging could be due to the increase in such cortical senile changes as that of microglia, astroglia, and senile plaques, which contain iron or iron-related proteins. The temporal cortex is most susceptible to senile changes. (K.H.)

[en] We compared characteristic features in ischemic stroke lesions from the hyperacute to the chronic stage on diffusion-weighted (DW) and magnetization transfer (MT) images with those on T2-weighted (T2W) images, and assessed changes in apparent diffusion coefficient (ADC), MT effect (MTe), and T2 ratios (infarct/normal) over time. DW images were particularly useful for detecting hyperacute infarcts within 6 hours of onset and in distinguishing acute lesions from chronic lesions. ADC ratios were lower within 7 days after onset and rose toward 1.0 in the subacute phase, becoming relatively isotense on ADC maps, but elevated thereafter. Although MTe ratios were unchanged or only subtly changed in the acute stage, they became significantly lower in the subacute and chronic stages. These combined magnetic resonance (MR) techniques were useful in the assessment of ischemic stroke and facilitated the determination of the age of cerebral infarct. (author)

[en] We retrospectively studied magnetic resonance (MR) images of the brain in 139 patients (16 cases of Alzheimer's disease, 8 cases of Parkinson's disease, 53 cases of multiple cerebral infarct, 33 cases of other central nervous diseases, and 29 cases of peripheral neuropathy) between the age of 6 and 85 years old with a mean age of 60.6±18.5 to examine the appearance of T2 low signal intensity areas (T₂-CLIA) in the cerebral cortex. Motor, occipital, sensory or other cortices were evaluated with long repetition time/echo time (TR/TE) spin-echo sequences and staged into three grades in the motor cortex: none, partial, and whole; and two grades in the other: none or present. In general, T₂-CLIA was not seen in any cortex in patients less than 50 years old, then after 50 years old T₂-CLIA increased with age. Over 70 years of age T₂-CLIA appeared in 50.9% of patients in the whole motor cortex, 88.7% in either whole or partial motor cortex, 47.2% in the occipital cortex, and 20.8% in the sensory cortex. T₂-CLIA was not observed in other cortices. The incidence of T₂-CLIA appearance in the motor cortex was significantly higher in all central nervous diseases than in cases of peripheral neuropathy over 70. T₂-CLIA showed a correlation with temporal lobe atrophy and white matter lesions in the motor cortex. In the sensory cortex, T₂-CLIA correlated with white matter lesions. These results suggest that T₂-CLIA may correlate with age or accumulation of nonheme iron in the cortex associated with central nervous diseases. (author)