![]() ![]() ![]() as an observation in multiple system atrophy (MSA) patients with extrapyramidal symptoms and autonomic failure. It was first reported by Savoiardo et al. The term “hyperintense putaminal rim (HPR)” is commonly used to represent a linear hyperintensity at the lateral margin of the putamen on T2-weighted or proton-density-weighted images of the brain. #Mr photo 1.5 download full#Thin linear hyperintensity without discontinuity, occupying the full length or anterior half of the lateral margin of the putamen, is suggestive of “normal.” In doubtful cases, measurement of the MD values of nearby putamen may be valuable. HPR can be observed in 38.5% of normal subjects at 1.5 T. Patients with MSA of either type had significantly higher MD values of putamen than normal subjects. On visual analysis, the characteristics of HPR were similar between MSA-C patients and normal subjects. Discontinuity of HPR was more frequently observed in MSA-P. However, in MSA-P, HPR was located predominantly at the posterolateral aspect of putamen, and associated with putaminal atrophy. There was no association with hypointensity of nearby putamen. In most cases, it occupied the full length or anterior half of the lateral margin of putamen, and was continuous throughout its length. Age and gender predilection and laterality were not observed. HPR was observed in 38.5% of normal subjects. Fisher’s exact test, t-test, and one way analysis of variance were used to determine significance at corrected p < 0.05. The mean diffusivity (MD) values of putamen were also compared. The characteristics of HPR were compared between these patients and age-matched normal subjects. To distinguish from that observed in MSA, axial T2-weighted images of 6 MSA patients with predominant parkinsonism (MSA-P) and 15 MSA patients with predominant cerebellar symptoms (MSA-C) were also evaluated. MethodsĪxial T2-weighted images of 130 normal subjects were evaluated for the prevalence of HPR, its age and gender distribution, laterality, maximum dimension, association with hypointensity of nearby putamen, and presence of discontinuity. This study aimed to determine whether HPR could be observed in normal subjects at 1.5 T and if so, to establish its prevalence, the MRI characteristics, and the features which distinguish from HPR in MSA patients. Whether it can be observed in normal subjects at 1.5 T is not known. Recent studies have suggested that it can also be observed in normal subjects at 3 T. Hyperintense putaminal rim (HPR) is an important magnetic resonance imaging (MRI) sign for multiple system atrophy (MSA). ![]()
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