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Nigrosomes are calbindin-poor zones within the substantia nigra pars compacta, and are the primary subregion where dopaminergic cells are lost in Parkinson disease. High-resolution 3D multiecho imaging was performed at 3T in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by 18F-FP-CIT PET. Diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Further, the clinical laterality was in high concordance with the laterality of the nigrosome 1 detection.

Abstract

BACKGROUND AND PURPOSE

In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality.

MATERIALS AND METHODS

High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (18F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as “normal,” “possibly abnormal,” and “abnormal” by 2 independent reviewers. The degree of 18F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of 18F-FP-CIT binding were analyzed for agreement with clinical laterality.

RESULTS

The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the 18F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality.

CONCLUSIONS

The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).

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