Parkinson’s disease: diagnostic potential of high-resolution phase difference enhanced MR imaging at 3 T

Objectives To determine whether it is possible to diagnose patients with Parkinson’s disease (PD) on an individual basis using magnetic resonance imaging with phase difference enhanced imaging (PADRE). Methods PADRE delineated the crural fibres as a layer of low signal intensity and the substantia nigra as a layer of medium signal intensity in a healthy volunteer, and showed a clear boundary between the crural fibres and the substantia nigra (BCS). Twenty-four PD patients and 24 control subjects were enrolled. Contrast ratios between the substantia nigra and occipital white matter were calculated, and two radiologists independently reviewed the PADRE findings regarding BCS obscuration. Results Mean contrast ratio in PD patients was significantly higher than in control subjects (0.56 vs 0.39, P < 0.01). The BCS on PADRE was obscured significantly more frequently in any subgroups with PD patients compared with control subjects ( P < 0.01). The observation of BCS obscuration had a sensitivity, specificity and accuracy for the diagnosis of PD of 92 %, 88 % and 90 % for radiologist 1 and 83 %, 88 % and 85 % for radiologist 2, respectively. Conclusion PADRE is able to identify PD in patients as a loss of delineation between the crural fibres and the substantia nigra on an individual basis. Key Points • High-resolution phase difference enhanced 3-T MR imaging offers new insights into Parkinson’s disease • Phase imaging can delineate the boundary between crural fibres and substantia nigra • The boundary between crural fibres and substantia nigra is obscured in Parkinson’s disease • Phase difference enhanced imaging (PADRE) can identify individual patients with Parkinson’s disease