The role of SWI (mr images mapped by magnetic field inhomogeneity) in the differential diagnosis of Parkinson's disease

Abstract

Purpose. To compare the degree of iron accumulation in the basal ganglia according to SWI in Parkinson's disease at different stages with other diseases of the nervous system. Material and methods. 24 patients were examined, including 8 patients with Parkinson's disease at stage 2, 10 patients at stage 3 of Parkinson's disease with different disease duration (from 4 to 16 years), 3 patients with essential tremor and 3 patients with remitting-recurrent form of multiple sclerosis in the phase of stable remission. Patients underwent high-field MRI of the brain on a Siemens TrioTim with a magnetic field strength of 3T. In addition to the native pulse sequences, all patients underwent brain scans using the SWI protocol. Results. An increase in the intensity of MR-signal on SWI in Parkinson's disease in the black substance was revealed. The analysis of the results revealed a characteristic neu-roimaging picture of iron accumulation in the structures of the extrapyramidal system. Discussion. The most effective SWI was found in the case of differential diagnosis of idiopathic Parkinson's disease and essential tremor. In some cases, there is a very similar accumulation of iron in the structures of the basal ganglia, mainly in the black substance, in some other non-tumor diseases, for example, remitting-recurrent form of multiple sclerosis. This can be explained from the standpoint of oxidative stress occurring against the background of inflammation in the case of multiple sclerosis and does not lead to the development of the clinical picture of the defeat of the extrapyramidal system, since there is no death of neurons in these parts of the brain. Conclusion. SWI technique is a new and a very promising tool for differential diagnosis of diseases accompanied by lesions of the extrapyramidal system. In addition, it can be used to clarify the links of pathogenesis at different stages of Parkinson's disease, based on the dynamics of iron accumulation in the black substance and other basal ganglia during the disease.