Aim of the study Parkinson's disease is associated with iron deposition in the brain. The QSM (quantitative susceptibility mapping) is more sensitive than T2-weighted imaging, T2* and R2. Few studies have been used QSM to evaluate the iron in the basal ganglia of patients with Parkinson's disease. Our aim was to evaluate the iron deposition in the basal ganglia using QSM and determination of diagnostic value of this method and evaluation of the association between disease stage with QSM and age with QSM in all nuclei, separately. Materials and methods Thirty patients were tested using Hoehn and Yahr test in three different stages. Fifteen healthy subjects were considered as control group. MRI sequences were performed using SIEMENS 3 T scanner.The Signal Processing in NMR software was used to process and analyze the images. The QSM in every of the basal ganglia was measured separately. Results There was a significant difference for QSM in the Subtania Nigera, Red Nucleus, Thalamic Nucleus and Globus Pallidus nucleus between two groups. The relationship between disease stage with QSM was significant in Subtania Nigera, Red Nucleus, and Globus Pallidus nucleus. The QSM values had a significant association with disease stage in all nuclei. The results showed that QSM has a higher accuracy in Subtania Nigera, Globus Pallidus, Red Nucleus and Thalamic Nucleus, respectively. Conclusions Using QSM in Red Nucleus, Subtania Nigera, and Globus Pallidus nuclei can help diagnosis and staging the patients with Parkinson's disease. In future, studies with emphasis on the disease stage can be helpful in evaluation the different parts of these three nuclei.

BackgroundMultiple sclerosis (MS) is a demyelinating disease of the central nervous system. MRI has an important role in early diagnosis of MS within diagnostic criteria.AimTo determine the diagnostic value of the double inversion recovery (DIR) sequence in detection of brain MS lesions.MethodsIn this cross-sectional study, 55 patients were admitted to the MRI department in Vali-E-Asr Hospital in Qaemshahr, Iran, from May 2016 to February 2016. Imaging was performed on a 1.5T Philips MR system using DIR, fluid attenuated inversion recovery (FLAIR), and T2-weighted turbo spin echo (T2W_TSE) sequences with the same parameters, including field of view (FOV), matrix, slice thickness, voxel size, and number of signal averaging (NSA). The DIR sequence has two different time inversions (TI1=3400, TI2=325ms): suppressing cerebrospinal fluid (CSF) and white matter signal. Data analysis was performed using the SPSS version 20, and p-value was gained from the patient-wise analysis by Wilcoxon analysis and paired samples t-test for matched pairs.ResultsMore lesions in number and size were depicted on the DIR sequence compared with FLAIR (p=0.000 with a relative ratio of 6) and T2W_TSE (p=0.000 with a relative ratio of 10). DIR demonstrated significantly more intracortical lesions compared with FLAIR (p=0.000 with a relative ratio of 2.53) and T2W_TSE (p=0.000 and relative ratio of 8.87). There was significantly higher contrast ratio between the white matter lesions and the normal appearing white matter (NAWM) in all anatomical regions especially in deep white matter (p=0.001).ConclusionAn increasing total number of MS lesions can be detected by DIR sequence; thus, we recommend adding DIR sequence in routine MR protocols for MS patients.

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Purposeto evaluate diagnostic value and image quality of T2-weighted Three-dimensional isotropic turbo spin-echo (SPACE) in comparison with T2-weighted two-dimensional turbo spin-echo (TSE) sequences for comprehensive evaluation of lumbar spine pathologies.Materials and methodsThirty-five participants with lumbar discopathy were examined on a 1.5-T MRI system with both 2D TSE and 3D SPACE sequences. Obtained images were analyzed with synedra view personal (V 17.0.0.2) software in terms of calculating image quality factors such as signal to noise ratio (SNR) and contrast to noise ratio (CNR) for selected regions of interest. In addition, images were referred to radiologists to report their pathologic indexes. The visibility of anatomical structures in the 3D and 2D sequences was qualitatively assessed by two radiologists independently. Cohen's kappa (k) and Wilcoxon signed rank test was used for the statistical analysis.ResultsIn this study, the 3D SPACE T2-weighted sequence showed significant higher SNR and CNR as well as visibility in all of the regions of interest except vertebrae and intervertebral discs (p-value < 0.05). Inter-observer agreement for visibility of regions of interest was substantial and perfect (k > 0.6). Also, inter-observer and inter-method agreements for pathologic indexes were substantial and perfect for all of the pathologic indexes (k > 0.6). Inter-observer agreement for 3D SPACE sequence was higher (k = 0.793) in comparison with 2D-TSE sequence (k = 0.603). 3D SPACE sequence and its multi-planar reconstructions (MPR) scan time were less (192 s) than 2D TSE in the sagittal, axial and coronal planes (209 s).Conclusion3D SPACE sequence for lumbar spine MRI proved to have higher SNR, CNR, and visibility for all regions of lumbar spine except vertebrae and disc. Inter-observer and inter-method agreements for pathologic indexes between 3D SPACE and 2D TSE sequences were substantial and 3D SPACE had a higher inter-observer agreement and less scan time. Therefore, T2 weighted 3D SPACE sequence, and its MPR might be an excellent alternative for 2D TSE in sagittal, axial, and coronal planes, especially for patients with abnormal curvature of the lumbar spine.