The agreement between neuropathologists was substantial both for periventricular (kappa of 0.65; 95% CI: 0.60 - 0.85; p<0.0001) and deep WM demyelination (kappa of 0.78; 95% CI: 0.59 - 0.95; p<0.0001)). Scattered T2 and FLAIR hyperintense foci identified in subcortical and periventricular white matter which are nonspecific. What it means Signal area hyperintense on T2 and FLAIR in the white matter anterior to the left nucleus-capsular region, which may represent an area of encephalomalacia.. White matter changes were defined as "ill-defined hyperintensities >= 5 mm. 10.1161/01.STR.28.3.652, O'Sullivan M, Lythgoe DJ, Pereira AC, Summers PE, Jarosz JM, Williams SC: Patterns of cerebral blood flow reduction in patients with ischemic leukoaraiosis. Lancet 2000, 356: 628634. Untreated, it can lead to dementia, stroke and difficulty walking. However, there are numerous non-vascular The coefficient of determination (R2) was used to assess the proportion of variance explained by the models. This article requires a subscription to view the full text. A review by Debette and Markus sought to review the evidence of the association between WMHs and the risk of cognitive impairment, dementia, death and stroke. There is strong evidence that WMH are clinically important markers of increased risk of stroke, dementia, death, depression, impaired gait, and mobility, in cross-sectional and in longitudinal studies. WMHs may, therefore, be a marker for diffuse vascular involvement including peripheral and coronary arteries increasing the risk of cardiovascular mortality. We also identified a subset of 14 cases in the whole series that displayed prominent T2/FLAIR WMHs around perivascular spaces on brain MRI defined as confluent T2/FLAIR lesion immediately adjacent to prominent and clearly visible perivascular spaces on T2w (see Figure2). In the United States, you can find a network of imaging centers that facilitate patients. et al. Lesions are not the only water-dense areas of the central nervous system, however. SH, K-OL, EK, and CB designed the study. I dropped them off at the neurologist this morning but he isn't in until Tuesday. Other risk factors for white spots include getting older, race/ethnicity, genetics, obesity, diabetes, hypertension, and high cholesterol. Focal hyperintensities in the subcortical white matter demonstrated by T2-weighted or FLAIR images are a common incidental finding in patients undergoing brain MRI for indications other than stroke. [Read more on melancholic depression and association of WMHs with structural melancholia), They are also closely associated with late-onset depression and their progression is associated with worse outcomes in geriatric depression. Therefore, the doctors focus on neurological evaluation when assessing the MRI reports providing the diagnosis accordingly.. All authors participated in the data interpretation. height: "640px", White matter hyperintensity accumulation during treatment of late-life depression. This file may have been moved or deleted. These white matter hyperintensities are an indication of chronic cerebrovascular disease. I am a PhD-trained biochemist and neuroscientist with over 9 years of research experience in the field of neurodegenerative diseases. Come and explore the metaphysical and holistic worlds through Urban Suburban Shamanism/Medicine Man Series. They are non-specific. Matthews about dizziness, there can be few physicians so dedicated to their art that they do not experience a slight decline in spirits when they learn that a patients brain MRI shows nonspecific white matter T2-hyperintense lesions compatible with microvascular disease, demyelination, migraine, or other causes. Among these lesions, degeneration of myelin is the most frequently encountered in old age and may take place long before the emergence of cognitive or affective symptoms [14]. Arch Neurol 1991, 48: 293298. As it is not superficial, possibly previous bleeding (stroke or trauma). An MRI report can call white matter changes a few different things, including: Cerebral or subcortical white matter disease or lesions. However, the level of impact relies on the severity and localization of the MRI hyperintensity., The health practitioners also state that MRI hyperintensity is also associated with the decline in cognitive behavior. However, this association remained modest since radiological scores explained only 15 to 22% of the variability in pathological scores. WebHyperintensities are often not visible on other types of scans, such as CT or FLAIR. Sensitivity value for radiological cut-off was modest at 44% but specificity was good at 88% (Table1). 10.1212/WNL.43.9.1683, Grafton ST, Sumi SM, Stimac GK, Alvord ECJ, Shaw CM, Nochlin D: Comparison of postmortem magnetic resonance imaging and neuropathologic findings in the cerebral white matter. Welcome to Iggy Garcia, The Naked Shaman Podcast, where amazing things happen. Im an obsessive learner who spends time reading, writing, producing and hosting Iggy LIVE and WithInsightsRadio.com My biggest passion is creating community through drumming, dance, song and sacred ceremonies from my homeland and other indigenous teachings. The multifocal periventricular and posterior fossa white matter lesions have an appearance typical of demyelinating disease. Dr. Judy is a Prophet, Pastor and Life Coach. They are indicative of chronic microvascular disease. It was amazing and challenging growing up in two different worlds and learning to navigate and merging two different cultures into my life, but I must say the world is my playground and I have fun on Mother Earth. 134 cases had a pre-mortem brain MRI on the local radiological database. WebWhite matter changes are visible on magnetic resonance imaging (MRI) as lesions. Non-specific white matter changes. It has become common around the world. We computed average scores within each group and then dichotomized the averaged scores using a threshold of 1.5. 2023 BioMed Central Ltd unless otherwise stated. There are several different causes of hyperintensity on T2 images. 10.1212/01.wnl.0000249119.95747.1f, Krishnan MS, O'Brien JT, Firbank MJ, Pantoni L, Carlucci G, Erkinjuntti T: Relationship between periventricular and deep white matter lesions and depressive symptoms in older people. You dont need to panic as most laboratories have advanced wide-bore MRI and open MRI machines. The present study is based on a larger sample of carefully selected cases with preserved cognition. This tissue contains millions of nerve fibers, or axons, that connect other parts of the brain and spinal cord and signal your nerves to talk to one another. Histological slides were independently evaluated by two trained neuropathologists without previous knowledge of the MRI data. What does scattered small foci of t2 hyperintensity in the subcortical white matter means. Radiologists overestimated these lesions in 16 cases. Normal vascular flow voids identified at the skull base. The present study revealed that brain T2/FLAIR sequence-identified WMHs overestimated demyelination in the periventricular and perivascular regions but underestimated it in the deep WM during normal brain aging. In multiple linear regression models, the only variable significantly associated with the neuropathologic score was the radiological score (regression coefficient 0.21; 95% CI: 0.04-0.38; p=0.019) that explained 15% of its variance. Brain Res Rev 2009, 62: 1932. Neuro patients going in for head and cervical MRI should ask to see if they are being imaged on a 3.0 Tesla MRI using an MS imaging protocol. There are seve= ral (approximately eight) punctate foci of T2 and FLAIR hyperintensit= y within the cerebral white matter. T1 Scans with Contrast. Google Scholar, Douek P, Turner R, Pekar J, Le Patronas N, Bihan D: MR color mapping of myelin fiber orientation. This tissue contains millions of nerve fibers, or axons, that connect other parts of the brain and spinal cord and signal your nerves to talk to one another. An MRI report can call white matter changes a few different things, including: Cerebral or subcortical white matter disease or lesions. My 1.5 Tesla study was like flushing $1800 down the crapper. The ventricles and basilar cisterns are symmetric in size and configuration. We analyzed the pathological significance of T2/FLAIR sequences since they are the most widely available in routine clinical settings. Again, all tests were repeated with a subsample of 33 cases with delay between MRI and autopsy less than 5 years. Major imaged intracranial flow = voids appear normally preserved. Largely it defines the brain composition and weighs the reliability of the spinal cord. WMHs are also referred to as Leukoaraiosis and are often found in CT or MRIs of older patients. In medicine, MRI hyperintensity is available in three forms according to its location on the brain. Periventricular White Matter Hyperintensities on a T2 MRI image a focus of T2 hyperINTENSITY means that the signal from that area has different tissue characteristics compared to normal brian tissue. This scale is a 4 point one, based on MRI images with either proton density (PD), T2, or T2-FLAIR. The wide space makes it easier to conduct brain MRI and other body parts as required., The open MRI involves an open machine that uses magnets to take inside images from all four sides., As compared to ultrasound and CT scans, MRI has more advantages. Neurology 2011, 76: 14921499. Additionally, these changes are differentially distributed among those patients who are eventually classified as non-remitters, which indicates that the relationship between WMH accumulation and Late life depression (LLD) is consequential even during short antidepressant treatment courses. Symptoms of white matter disease may include: issues with balance. Analysis of cohorts of consecutive subjects aged 55 to 85 years living at home. These lesions were typically located in the parietal lobes between periventricular and deep white matter. T2 hyperintensities (lesions). These areas are hyperintense on T2-weighted (T2) and fluid-attenuated inversion recovery (FLAIR) MRI sequences, and by consensus are now referred to as white matter hyperintensities (WMH), or subcortical hyperintensities where deep gray matter is also involved. 10.1136/jnnp.2009.172072, Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F: Pathologic correlates of incidental MRI white matter signal hyperintensities. They are more common in individuals with a history of cognitive impairment, dementia, or cerebrovascular disease. 10.1093/brain/114.2.761, Young VG, Halliday GM, Kril JJ: Neuropathologic correlates of white matter hyperintensities. In this episode I will speak about our destiny and how to be spiritual in hard times. Matthews about dizziness, there can be few physicians so dedicated to their art that they do not experience a slight decline in spirits when they learn that a patients brain MRI shows nonspecific white matter T2-hyperintense lesions compatible with microvascular disease, demyelination, migraine, or other causes. Another limitation concerns certain a priori choices in respect to the radiological and neuropathological investigations. WebT2-FLAIR stands for T2-weighted- F luid- A ttenuated I nversion R ecovery. Due to the period of 10 years, the exact MRI parameters varied. It indicates the lesions, their volume, and their frequency. WebWith the wide use of brain MRI, white matter hyperintensity (WMH) is frequently observed in clinical patients. WebAnswer (1 of 8): White matter hyperintensities (WMHs) are signal abnormalities in the white matter of the brain found on T2-weighted , fluid-attenuated inversion recovery (FLAIR), and proton density magnetic resonance imaging (MRI) sequences. Additionally, axial T1w, T1w after Gadolinium administration and T2*w images were analyzed to rule out concomitant brain pathological findings. While these findings are non specific they are commonly seen with chronic microvascular ischemic change. These include: Leukoaraiosis. Access to this article can also be purchased. My PassionHere is a clip of me speaking & podcasting CLICK HERE! There was a fair agreement between neuropathologists and radiologists for periventricular lesions with kappa value of 0.31 (95% CI: -0.03 - 0.59; p=0.023). Usually this is due to an increased water content of the tissue. 10.1161/STROKEAHA.108.528299, Folstein MF, Folstein SE, McHugh PR: "Mini-mental state". I dropped them off at the neurologist this morning but he isn't in until Tuesday. Top Magn Reson Imaging 2004, 15: 365367. Susceptibility weighted imaging demonstrates no evid= ence of prior parenchymal hemorrhage. It also assesses the structure of the heart and aorta., The term MRI hyperintensity defines how components of the scan look. MRI said few tiny discrete foci of high signal on FLAIR sequences in the deep white matter in the cerebellum, possibly part of chronic small vessel disease. Discordant pairs were analyzed with exact Mc Nemar significance probability. White matter hyperintensity progression and late-life depression outcomes. White matter hyperintensities (WMH) lesions on T2 and fluid attenuated inversion recovery (FLAIR) brain MRI are very common findings in elderly cohorts and their prevalence increases from 15% at the age of 60 to 80% at the age of 80 [14].Mainly located in the periventricular white matter (WM) and perivascular spaces, they can also be WebAnswer (1 of 2): Exactly that. The MRI imaging presents a range of sequences. Consequently, a relatively low degree of histopathologically documented demyelination may be sufficient to induce T2/FLAIR signal alterations. These areas are hyperintense on T2-weighted (T2) and fluid-attenuated inversion recovery (FLAIR) MRI sequences, and by consensus are now referred to as white matter hyperintensities (WMH), or subcortical hyperintensities where deep gray matter is also involved. The deep WMHs were defined as T2/FLAIR signal alterations distant from the ventricular system. There are seve= ral (approximately eight) punctate foci of T2 and FLAIR hyperintensit= y within the cerebral white matter. Stroke 2009, 40: 20042011. FLAIR vascular hyperintensities are hyperintensities encountered on FLAIR sequences within subarachnoid arteries related to impaired vascular hemodynamics 1,2.They are usually seen in the setting of acute ischemic stroke and represent slow retrograde flow through collaterals (and not thrombus) distal to the site of occlusion 3.. A radiologic-neuropathologic correlation study, http://creativecommons.org/licenses/by/2.0. Cause of death were 30 (50.9%) bronchopneumonia, 9 (15.3%) cancer, 7 (11.9%) cardiovascular, 5 (8.5%) sepsis, 3 (5.1%) pulmonary emboli, 2 (3.4%) brain hemorrhagia and 3 others. However, this statistical approach may overestimate the concordance values in the present study. 1 The situation is As expected, slice thickness was very different in MRI compared to neuropathological analysis. WebWith the wide use of brain MRI, white matter hyperintensity (WMH) is frequently observed in clinical patients. There are many possible causes, including vitamin deficiencies, infections, migraines, and strokes. No evidence of midline shift or mass effect. To this end, the T1- and T2-weighted, as well as the T2-weighted FLAIR, magnetic resonance imaging (MRI) data obtained from migraine patients were analyzed to describe the imaging characteristics of WMHs. The threshold of 1.5 corresponds to the rounding of the scores to the nearest integer values. On the contrary, hypointensity would be blacker in color., The MRI hyperintensity reflects the existence of lesions in the brain. Its not easy for common people to understand the neuropathology of MRI hyperintensity. Although some WMH is associated with specific causes, such as lacunar infarction, traumatic brain injury, and demyelinating disease [13], some WMH has no specific cause, especially in young patients.Incidental WMH without a detected cause can be In medicine, MRI hyperintensity is available in three forms according to its location on the brain. We tested the hypothesis that periventricular WMHs might overestimate demyelination given the relatively high local concentration of water in this brain area. There are really three important sections of the brain when it comes to hyperintensities: the periventricular white matter, the deep white matter, and the subcortical white matter. MRI indicates a few scattered foci of T2/FLAIR hyperintensities in the pons, periventricular and subcortical white matter. WebMri few punctate t2 and flair hyperintense foci in the periventricular white matter, likely related to chronic small vessel ischemia.what it means. An MRI scan is one of the most refined imaging processes. T2-FLAIR. volume1, Articlenumber:14 (2013) Consistent with the very old age of our cohort [16], three cases showed Braak stages 5 for neurofibrillary tangles [17] and 8 cases had at least one cortical Lewy body [18]. We used to call them UBOs; Unidentified bright objects. Herrmann LL, Le Masurier M, Ebmeier KP: White matter hyperintensities in late life depression: a systematic review. If you have a subscription you may use the login form below to view the article. (A) Good correlation between radiology and pathology for both periventricular (arrowhead) and deep WM (arrow) lesions; (B) radiological assessment over-estimating periventricular lesions; (C) under-estimating deep WM lesions; (D) over-estimating periventricular lesions and under-estimating deep WM lesions. From paraffin-embedded blocs 2 consecutive 12 m thick slides were cut and stained with Luxol-van Gieson staining for the visualization of myelin as well as haematoxylin-eosin and haematoxylin-eosin for cellular and structural analysis [20]. We report the radiologic-histopathologic concordance between T2/FLAIR WMHs and neuropathologically confirmed Areas of new, active inflammation in the brain become white on T1 scans with contrast. Citation, DOI & article data. T2/FLAIR WMHs overestimate neuropathologically confirmed demyelination in the periventricular (p<0.001) areas but underestimates it in the deep WM (0<0.05). The assessment of the MRI hyperintensity lesions assists in diagnosing neurological disorders and other psychiatric illnesses.. It is a common finding on brain MRI and a wide range of differentials should It affects the brain of humans and is more prevalent in older people. They are considered a marker of small vessel disease. Coronal slice orientation during analysis was the same for radiology and neuropathology. Focal hyperintensities in the subcortical white matter demonstrated by T2-weighted or FLAIR images are a common incidental finding in patients undergoing brain MRI for indications other than stroke. This is the most common cause of hyperintensity on T2 images and is associated with aging. I have some pins and needles in hands and legs. WebMy MRI results were several punctate foci of T2 and flair signal hyperintensity within the subcortical white matter of the frontal lobes. Material/methods: Cerebral MRI results of 246 patients (134 females, 112 males), aged 2 -79 years, were While these findings are non specific they are commonly seen with chronic microvascular ischemic change. Sensitivity value for radiological cut-off was 38% (95% CI: 15% - 64%) but specificity reached 82% (95% CI: 57% - 96%). All included cases had axial spin-echo T2 and coronal FLAIR imaging. depression. Microvascular ischemic disease is a brain condition that commonly affects older people. Privacy Sensitivity value for radiological cut-off was excellent at 100% (95% CI: 48% - 100%) but specificity was modest at 43% (95% CI: 25% - 63%). All of the cases included in the present series presented with high MMSE scores compatible with normal cognitive functioning and absence of major depression. Therefore, it is identified as MRI hyperintensity.. Relevance to vascular cognitive impairment. These small regions of high intensity are observed on T2 weighted MRI images (typically created using 3D FLAIR) Untreated, it can lead to dementia, stroke and difficulty walking. White matter hyperintensities (WMHs) are lesions in the brain that show up as areas of increased brightness when visualised by T2-weighted magnetic resonance imaging (MRI). WebThe T2 MRI hyperintensity is often a sign of demyelinating illnesses. Appointments & Locations. Usually this is due to an increased water content of the tissue. Other risk factors for white spots include getting older, race/ethnicity, genetics, obesity, diabetes, hypertension, and high cholesterol. It is diagnosed based on visual assessment of white matter changes on imaging studies. statement and [21], the severity of periventricular and deep WM demyelination was assessed on a 4-level semi-quantitative scale, where 0 corresponded to absent; 1 to mild; 2 to moderate and 3 to severe demyelination. The ventricles and basilar cisterns are symmetric in size and configuration. This tissue contains millions of nerve fibers, or axons, that connect other parts of the brain and spinal cord and signal your nerves to talk to one another. They are considered a marker of small vessel disease. MRI showed some peripheral hyperintense foci in white matter. PubMed For more information, please visit: IggyGarcia.com & WithInsightsRadio.com, Welcome to Iggy Garcia, The Naked Shaman Podcast, where amazing things happen. We opted for this method in order to avoid that similar yet not identical categories would be classified as mismatch. Initially described in patients with cardiovascular risk factors and symptomatic cerebrovascular disease [4], WMHs are thought to have a deleterious effect on cognition and affect in old age (for review see [57]). You dont need to panic as most laboratories have advanced wide-bore MRI and, The MRI hyperintensity is a common imaging feature in T2. Finally, we assessed the effects of other clinical parameters using multiple linear regression models with the pathological score as the dependent variable and radiological score, age, sex, and delay between MRI and death as the independent variables. [Taylor W et al., 2003], WMH accumulation occurs over significantly shorter intervals (ie 12 weeks) than has been previously shown. 10.1212/WNL.0b013e318217e7c8, Article Microvascular disease. We report the radiologic-histopathologic concordance between T2/FLAIR WMHs and neuropathologically confirmed demyelination in the periventricular, perivascular and deep white matter (WM) areas. WebIs T2 FLAIR hyperintensity normal? Even when adjusting for vascular disease risk factors, such as age and high blood pressure, this association was still significant. b A punctate hyperintense lesion (arrow) in the right frontal lobe. They are indicative of chronic microvascular disease. Neuro patients going in for head and cervical MRI should ask to see if they are being imaged on a 3.0 Tesla MRI using an MS imaging protocol. White matter changes were defined as "ill-defined hyperintensities >= 5 mm. There are many possible causes, including vitamin deficiencies, infections, migraines, and strokes. It is an accurate method of detecting and confirming the diagnosis. FLAIR vascular hyperintensities are hyperintensities encountered on FLAIR sequences within subarachnoid arteries related to impaired vascular hemodynamics 1,2.They are usually seen in the setting of acute ischemic stroke and represent slow retrograde flow through collaterals (and not thrombus) distal to the site of occlusion 3.. As a result, it has become increasingly valuable in diagnosing health issues. It makes it easier for the doctors to assess the lesion, its cause, and its impact on the individuals health., The MRI hyperintensity is a common imaging feature in T2 MRI imaging reports. For more information, please visit: IggyGarcia.com & WithInsightsRadio.com, For more information, please visit: (Wahlund et al, 2001) An ependymal denudation of variable extension (at least of microscopic size) was present in all cases on the ventricular surface. Arch Gen Psychiatry 2000, 57: 10711076. MRI indicates a few scattered foci of T2/FLAIR hyperintensities in the pons, periventricular and subcortical white matter. They can pose serious diagnostic problems which is reflected by their English name and abbreviation - UBOs (Unidentified Bright Objects). If youre curious about my background and how I came to do what I do, you can visit my about page. MRI said few tiny discrete foci of high signal on FLAIR sequences in the deep white matter in the cerebellum, possibly part of chronic small vessel disease. 10.1212/WNL.47.5.1113, Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA: MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. Patients with migraine are at increased risk for white matter hyperintensities detected on magnetic resonance imaging. If you have a subscription you may use the login form below to view the article. Treatment typically involves reducing or managing risk factors, such as high blood pressure, cholesterol level, diabetes and smoking. 10.1161/STROKEAHA.107.489112, Service neuro-diagnostique et neuro-interventionnel DISIM, University Hospitals of Geneva, rue Gabrielle Perret-Gentil 4, Geneva 14, 1211, Switzerland, Sven Haller,Victor Cuvinciuc,Ann-Marie Tomm&Karl-Olof Lovblad, Department of Mental Health and Psychiatry, Geneva, Switzerland, Enik Kvari,Panteleimon Giannakopoulos&Constantin Bouras, Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland, Department of Readaptation and Palliative Medicine, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Geneva, Switzerland, You can also search for this author in WebThe most important scans are T1 scans with contrast and T2/FLAIR scans. These include: Leukoaraiosis. None are seen within the cerebell= um or brainstem. 2023. Specifically, WMHs can impact on memory, vigilance and executive functioning, depending on its localisation and severity. The inclusion of computer assisted data analysis such as machine-learning derived support vector machine analyses may allow for detecting subtle changes, which are not reliably detected by visual inspection [30, 31]. Scattered T2 and FLAIR hyperintense foci identified in subcortical and periventricular white matter which are nonspecific. Microvascular disease. WebWhite matter changes are visible on magnetic resonance imaging (MRI) as lesions. I have some pins and needles in hands and legs. T2 hyperintensities (lesions). T-tests were used to compare regression coefficients with zero. autostart: false, 10.1212/01.wnl.0000319691.50117.54. Two recent studies in healthy controls indicated that WMHs are associated with subtle executive dysfunctions and reduced speed of information processing [35, 36]. WebAbstract. They associate with brain damage such asglobal atrophy and other features of small vessel brain damage, with focal progressive visible brain damage, are markers of underlying subvisible diffuse brain damage, and predict infarct growth and worse outcome after large artery stroke. b A punctate hyperintense lesion (arrow) in the right frontal lobe. She is very prolific in delivering the message of Jesus Christ to the world, bringing people everywhere into a place of the victory God has prepared for them. The review showed that WMHs are significantly associated with an increased risk of stroke. 10.1007/s00401-012-1021-5, Santos M, Kovari E, Hof PR, Gold G, Bouras C, Giannakopoulos P: The impact of vascular burden on late-life depression. Stroke 1995, 26: 11711177. It has significantly revolutionized medicine. b A punctate hyperintense lesion (arrow) in the right frontal lobe. acta neuropathol commun 1, 14 (2013). EK and CB did data collection and histological analyses. For example, it can be used in brain imaging to suppress cerebrospinal fluid (CSF) effects on the image, so as to bring out the periventricular hyperintense lesions, such as multiple sclerosis (MS) plaques. unable to do more than one thing at a time, like talking while walking. (See Section 12.5, Differential Diagnosis of White Matter Lesions.) 12.3.2 Additional Imaging Recommended Postcontrast MRI of the brain should be obtained if gadolinium was not administered for the initial brain MRI. These lesions are best visualized as hyperintensities on T2 weighted and FLAIR (Fluid-attenuated inversion recovery) sequences of magnetic resonance imaging. (See Section 12.5, Differential Diagnosis of White Matter Lesions.) 12.3.2 Additional Imaging Recommended Postcontrast MRI of the brain should be obtained if gadolinium was not administered for the initial brain MRI. The MRI found: "Discrete foci T2/ FLAIR hyperintensity in the supratentorial white matter, non specific" When I saw this I about died.. Three trained neuroradiologists evaluated brain T2w and FLAIR MRI of all 59 cases blind to the neuropathologic data. It highlights the importance of managing the quality of MRI scans and images. P values inferior to 0.05 were considered significant. Wolff SD, Balaban RS: Magnetization transfer contrast (MTC) and tissue water proton relaxation in vivo. Google Scholar, Xekardaki A, Santos M, Hof P, Kovari E, Bouras C, Giannakopoulos P: Neuropathological substrates and structural changes in late-life depression: the impact of vascular burden. All authors approved the final version of the manuscript. Susceptibility weighted imaging demonstrates no evid= ence of prior parenchymal hemorrhage. In the same line, another cohort study supported the clinical relevance of deep WMHs that were correlated with cardiac arrhythmia, brain atrophy, and silent infarcts [2].

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