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The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy

BACKGROUND AND PURPOSE: The diagnosis of multiple system atrophy (MSA) remains challenging in clinical practice. This study investigated the value of hypointense signals in the putamen (“black straight-line sign”) in diffusion-weighted imaging (DWI) of brain MRI for distinguishing (MSA) from Parkins...

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Autores principales: Zheng, Yiming, Wang, Xiwen, Zhao, Huajian, Jiang, Yanyan, Zhu, Ying, Chen, Jing, Sun, Wei, Wang, Zhaoxia, Sun, Yunchuang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9161301/
https://www.ncbi.nlm.nih.gov/pubmed/35665040
http://dx.doi.org/10.3389/fneur.2022.890168
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author Zheng, Yiming
Wang, Xiwen
Zhao, Huajian
Jiang, Yanyan
Zhu, Ying
Chen, Jing
Sun, Wei
Wang, Zhaoxia
Sun, Yunchuang
author_facet Zheng, Yiming
Wang, Xiwen
Zhao, Huajian
Jiang, Yanyan
Zhu, Ying
Chen, Jing
Sun, Wei
Wang, Zhaoxia
Sun, Yunchuang
author_sort Zheng, Yiming
collection PubMed
description BACKGROUND AND PURPOSE: The diagnosis of multiple system atrophy (MSA) remains challenging in clinical practice. This study investigated the value of hypointense signals in the putamen (“black straight-line sign”) in diffusion-weighted imaging (DWI) of brain MRI for distinguishing (MSA) from Parkinson's disease (PD). METHODS: We retrospectively enrolled 30 MSA patients, 30 PD patients, and 30 healthy controls who had undergone brain MRI between 2016 and 2020. Two readers independently assessed the signal intensity of the bilateral putamen on DWI. The putaminal hypointensity was scored using 4-point visual scales. Putaminal hypointensity and the presence of a “black straight-line sign” were statistically compared between MSA and PD or healthy controls. RESULTS: The mean scores of putaminal hypointensity in DWI in the MSA group were significantly higher than in both the PD (U = 315.5, P = 0.034) and healthy control groups (U = 304.0, P = 0.022). Uni- or bilateral putaminal hypointensity in DWI with a score ≥2 was identified in 53.3% (16/30), 16.7% (5/30), and 13.3% (4/30) of MSA, PD, and healthy controls, respectively, with significant differences between MSA and PD (X(2) = 8.864, P = 0.003) or healthy controls (X(2) = 10.800, P = 0.001). Notably, the “black straight-line sign” of the putamen was observed in 16/30 (sensitivity 53.3%) patients with MSA, while it was absent in PD and healthy controls (specificity 100%). There were no significant differences for the presence of “black straight-line sign” in the MSA-P and MSA-C groups (X(2) = 0.433, P = 0.510). CONCLUSION: The “black straight-line sign” of the putamen in DWI of head MRIs has the potential to serve as a diagnostic marker for distinguishing MSA from PD.
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spelling pubmed-91613012022-06-03 The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy Zheng, Yiming Wang, Xiwen Zhao, Huajian Jiang, Yanyan Zhu, Ying Chen, Jing Sun, Wei Wang, Zhaoxia Sun, Yunchuang Front Neurol Neurology BACKGROUND AND PURPOSE: The diagnosis of multiple system atrophy (MSA) remains challenging in clinical practice. This study investigated the value of hypointense signals in the putamen (“black straight-line sign”) in diffusion-weighted imaging (DWI) of brain MRI for distinguishing (MSA) from Parkinson's disease (PD). METHODS: We retrospectively enrolled 30 MSA patients, 30 PD patients, and 30 healthy controls who had undergone brain MRI between 2016 and 2020. Two readers independently assessed the signal intensity of the bilateral putamen on DWI. The putaminal hypointensity was scored using 4-point visual scales. Putaminal hypointensity and the presence of a “black straight-line sign” were statistically compared between MSA and PD or healthy controls. RESULTS: The mean scores of putaminal hypointensity in DWI in the MSA group were significantly higher than in both the PD (U = 315.5, P = 0.034) and healthy control groups (U = 304.0, P = 0.022). Uni- or bilateral putaminal hypointensity in DWI with a score ≥2 was identified in 53.3% (16/30), 16.7% (5/30), and 13.3% (4/30) of MSA, PD, and healthy controls, respectively, with significant differences between MSA and PD (X(2) = 8.864, P = 0.003) or healthy controls (X(2) = 10.800, P = 0.001). Notably, the “black straight-line sign” of the putamen was observed in 16/30 (sensitivity 53.3%) patients with MSA, while it was absent in PD and healthy controls (specificity 100%). There were no significant differences for the presence of “black straight-line sign” in the MSA-P and MSA-C groups (X(2) = 0.433, P = 0.510). CONCLUSION: The “black straight-line sign” of the putamen in DWI of head MRIs has the potential to serve as a diagnostic marker for distinguishing MSA from PD. Frontiers Media S.A. 2022-05-19 /pmc/articles/PMC9161301/ /pubmed/35665040 http://dx.doi.org/10.3389/fneur.2022.890168 Text en Copyright © 2022 Zheng, Wang, Zhao, Jiang, Zhu, Chen, Sun, Wang and Sun. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Zheng, Yiming
Wang, Xiwen
Zhao, Huajian
Jiang, Yanyan
Zhu, Ying
Chen, Jing
Sun, Wei
Wang, Zhaoxia
Sun, Yunchuang
The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy
title The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy
title_full The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy
title_fullStr The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy
title_full_unstemmed The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy
title_short The “Black Straight-Line Sign” in the Putamen in Diffusion-Weighted Imaging: A Potential Diagnostic MRI Marker for Multiple System Atrophy
title_sort “black straight-line sign” in the putamen in diffusion-weighted imaging: a potential diagnostic mri marker for multiple system atrophy
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9161301/
https://www.ncbi.nlm.nih.gov/pubmed/35665040
http://dx.doi.org/10.3389/fneur.2022.890168
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