Hyperintense dentate nucleus on unenhanced T1-weighted MR images is associated with a history of brain irradiation.

PURPOSE To assess the frequency of hyperintensity in the dentate nucleus on T1-weighted magnetic resonance (MR) images and to establish correlations between such hyperintensity and clinical factors, including a history of brain irradiation. MATERIALS AND METHODS This study was approved by the institutional review board, and each patient provided written informed consent. Three hundred sixty-two patients (164 men, 198 women; mean age, 62 years) were evaluated. Unenhanced T1-weighted MR images were obtained by using a spin-echo sequence at 3.0 T. Two neuroradiologists, who were blinded to clinical data, independently evaluated the signal intensity of the dentate nucleus compared with the signal intensity of the central white matter of the cerebellum by using a four-point graded response scale (grade 4 indicated prominent hyperintensity; grade 3, faint hyperintensity; grade 2, isointensity; and grade 1, hypointensity). Backward stepwise regression analysis was used to evaluate the relationship between signal intensity grades and the following clinical factors: sex, age, the interaction between age and sex, hypertension, dyslipidemia, diabetes mellitus, liver dysfunction, brain infarction, brain tumor, spinocerebellar degeneration, multiple sclerosis, a history of chemotherapy, and a history of brain irradiation. RESULTS T1-hyperintense dentate nuclei were present in 41 (11%) of the 362 patients. Of these 41 patients, 31 (76%) had a history of brain irradiation. Signal intensity grade of the dentate nucleus on T1-weighted MR images correlated significantly with a history of brain irradiation (P < .001) but no other clinical factor. CONCLUSION A hyperintense dentate nucleus may be seen on unenhanced T1-weighted MR images in some patients and may be associated with a history of brain irradiation.

[1]  S. Urayama,et al.  Spin-echo T1-weighted imaging of the brain with interleaved acquisition and presaturation pulse at 3 T: a feasibility study before clinical use. , 2009, Academic radiology.

[2]  Luca Roccatagliata,et al.  Multiple sclerosis: hyperintense dentate nucleus on unenhanced T1-weighted MR images is associated with the secondary progressive subtype. , 2009, Radiology.

[3]  Takashi Hanakawa,et al.  Gray matter-white matter contrast on spin-echo T1-weighted images at 3 T and 1.5 T: a quantitative comparison study , 2007, European Radiology.

[4]  Weiling Zhao,et al.  Chronic oxidative stress and radiation‐induced late normal tissue injury: a review , 2004, International journal of radiation biology.

[5]  T. Taoka,et al.  Magnetic resonance imaging shows delayed ischemic striatal neurodegeneration , 2003, Annals of neurology.

[6]  T. Taoka,et al.  Delayed ischemic hyperintensity on T1-weighted MRI in the caudoputamen and cerebral cortex of humans after spectacular shrinking deficit. , 1999, Stroke.

[7]  M. Teng,et al.  Hemichorea-hemiballism: an explanation for MR signal changes. , 1998, AJNR. American journal of neuroradiology.

[8]  J. Garcìa,et al.  Incomplete infarct and delayed neuronal death after transient middle cerebral artery occlusion in rats. , 1997, Stroke.

[9]  C. Weiller,et al.  Ischemic stroke and incomplete infarction. , 1996, Stroke.

[10]  D. Shanley.  Mineralizing microangiopathy: CT and MRI , 1995, Neuroradiology.

[11]  G. Davies-Jones,et al.  MR imaging in acute multiple sclerosis: ringlike appearance in plaques suggesting the presence of paramagnetic free radicals. , 1992, AJNR. American journal of neuroradiology.

[12]  P. Burger,et al.  Non-heme mechanisms for T1 shortening: pathologic, CT, and MR elucidation. , 1992, AJNR. American journal of neuroradiology.

[13]  R. Henkelman,et al.  High signal intensity in MR images of calcified brain tissue. , 1991, Radiology.

[14]  A J Barkovich,et al.  Normal deposition of brain iron in childhood and adolescence: MR imaging at 1.5 T. , 1989, Radiology.

[15]  R. Jennis,et al.  MR imaging of brain abscesses. , 1989, AJR. American journal of roentgenology.

[16]  B. Drayer,et al.  Imaging of the aging brain. Part I. Normal findings. , 1988, Radiology.

[17]  Y. Y. Lee,et al.  Computed tomography findings of severe mineralizing microangiopathy in the brain. , 1986, The Journal of computed tomography.

[18]  J. Barnhart,et al.  Influence of paramagnetic ions and pH on proton NMR relaxation of biologic fluids. , 1986, Investigative radiology.

[19]  J. Kurtzke.  Rating neurologic impairment in multiple sclerosis , 1983, Neurology.

[20]  S. Marklund,et al.  Human copper-containing superoxide dismutase of high molecular weight. , 1982, Proceedings of the National Academy of Sciences of the United States of America.

[21]  N. Lassen.  Incomplete cerebral infarction‐‐focal incomplete ischemic tissue necrosis not leading to emollision. , 1982, Stroke.

[22]  H. Shibasaki,et al.  Racial modification of clinical picture of multiple sclerosis Comparison between British and Japanese patients , 1981, Journal of the Neurological Sciences.

[23]  I. Fridovich,et al.  Mitochondrial superoxide simutase. Site of synthesis and intramitochondrial localization. , 1973, The Journal of biological chemistry.

[24]  B. Reilly,et al.  Calcification of the basal ganglia following radiation therapy. , 1970, The American journal of roentgenology, radium therapy, and nuclear medicine.

[25]  J. Hennel,et al.  Proton Magnetic Relaxation and Protein Hydration , 1963, Nature.

[26]  B. Hallgren,et al.  THE EFFECT OF AGE ON THE NON‐HAEMIN IRON IN THE HUMAN BRAIN , 1958, Journal of neurochemistry.

[27]  Y. Araki,et al.  High field MR imaging of the brain in pseudohypoparathyroidism , 2004, Neuroradiology.

[28]  T. Morioka,et al.  Radiation-Induced Brain Calcification: Paradoxical High Signal Intensity in T1-Weighted MR Images , 2000, Acta Neurochirurgica.

[29]  W P Dillon,et al.  Radiation injury of the brain. , 1991, AJNR. American journal of neuroradiology.

[30]  K. F. Lee,et al.  CT evidence of grey matter calcification secondary to radiation therapy. , 1977, Computerized tomography.