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MRI and pathological examination of post-mortem brains: the problem of white matter high signal areas

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Abstract

We examined 21 brains from individuals more than 65 years of age by MRI and neuropathological methods to study the frequency and morphology of white matter changes. There were 16 brains from neurologically normal subjects (Group 1) while the remaining 5 (Group 2) had neurological disturbances. In Group 1 MRI showed high signal areas in the periventricular white matter in 12 brains and in the deep white matter in 9. All had focal areas, with confluent zones in 4; 3 cystic infarcts were also detected. Neuropathology in this Group showed periventricular changes of variable extent in all cases, vacuolated myelin around the perivascular spaces in 14 and degenerate myelin in 4. Macroscopic inspection showed 3 cystic lacunar infarcts, while areas of recent infarction were present on histology in 2. Four of the Group 2 brains had periventricular MRI changes; high signal areas in deep white matter were focal in 2 and confluent in 1. Cystic infarcts were detected in 3 cases. Neuropathology showed periventricular changes in all the brains; in 4 myelin around the perivascular spaces was vacuolated while degenerate myelin was demonstrated in 1. There were also old (1) and recent (2) lacunar infarcts. High signal areas in the white matter thus have different histological backgrounds but only in a minority of cases do they seem to be of pathological significance and, as a rule, they are not related to the presence of neurological disturbances. Correlative MRI-neuropathological studies are helpful for characterising abnormalities detected by techniques, like MRI, which are sensitive but not very specific.

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References

  1. Hendrie HC, Farlow MR, Austrom MG, Edwards MK, Williams MA (1988) Foci of increased T2 signal intensity in brain MR scans of healthy elderly subjects. AJNR 10: 703–707

    Google Scholar 

  2. George AE, De Leon MJ, Kalnin A, Rosner L, Goodgold A, Chase N (1986) Leucoencephalopathy in normal and pathologic aging. 2. MRI of brain lucencies. AJNR 7: 567–570

    Google Scholar 

  3. Drayer BP (1988) Imaging of the ageing brain. Part I. Normal findings. Radiology 166: 785–796

    Google Scholar 

  4. Drayer BP (1988) Imaging of the aging brain. Part II. Pathologic conditions. Radiology 166: 797–806

    Google Scholar 

  5. Sze G, De Armond SJ, Brant-Zawadzki M, Davis RL, Norman D, Newton TH (1986) Foci of MRI signal (Pseudo lesions) anterior to the frontal horns: histologic correlations of a normal finding. AJR 147: 331–337

    Google Scholar 

  6. Braffman BH, Zimmerman RA, Trojanowsky JQ, Gonatas NK, Hickey WF, Schlaepfer WW (1988) Brain MR: pathologic correlation with gross and histopathology. 1. Lacunar infarction and Virchow-Robin spaces AJNR 9: 621–628

    Google Scholar 

  7. Braffman BH, Zimmerman RA, Troianowski JQ, Gonatas NK, Hickey WF, Schlaepfer WW (1988) Brain MR: Pathologic correlation with gross and histopathology. 2. Hyperintense whitematter foci in the elderly. AJNR 9: 629–636

    Google Scholar 

  8. Gupta SR, Naheedy MH, Young JC, Ghobrial M, Rubino F, Hindo W (1988) Periventricular white matter changes in dementia. Arch Neurol 45: 637–641

    Google Scholar 

  9. Fazekas F, Kleinert R, Offenbacher H, Payer F, Schmidt R, Kleinert G, Radner H, Lechner H (1991), The morphologic correlate of incidental punctate white matter hyperintensities on MR images. AJNR 12: 915–921

    Google Scholar 

  10. Gianpalmo A, Buffa D, Quaglia AC, Pesce CM (1988) Common senile degeneration and degenerative diseases of senility and pre-senility of the brain: a perspective. Hum Pathol 20: 7–17

    Google Scholar 

  11. Zimmerman RD, Fleming CA, Lee BCP, Saint-Louis LA, Deck MDF (1986) Periventricular hyperintensity as seen by magnetic resonance: prevalence and significance. AJNR 7: 13–20

    Google Scholar 

  12. Kirkpatrick JB, Hayman LA (1987) White-matter lesions in MR imaging of clinically healthy brains of elderly subjects: possible pathologic basis. Neuroradiology 162: 509–511

    Google Scholar 

  13. Grafton ST, Sumi SM, Stimac GK, Alvord EC, Shaw CM, Nochlin D (1991) Comparison of postmortem magnetic resonance imaging and neuropathologic findings in the cerebral white matter. Arch Neurol 48: 293–298

    Google Scholar 

  14. Leifer D, Buonanno FS, Richardson EP Jr (1990) Clinicopathologic correlations of cranial magnetic resonance imaging of periventricular white matter. Neurology 40: 911–918

    Google Scholar 

  15. Dooling EC, Chi JG, Gilles FH (1983) Developmental changes in ventricular epithelia. In: Gilles FH, Leviton A, Dooling EC (eds) The developing human brain: growth and epidemiologic neuropathology. John Wright-PSG, Boston, pp 113–116

    Google Scholar 

  16. Garcia JH (1983) Ischemic injuries of the brain. Morphologic Evolution. Arch Pathol Lab Med 107: 157–161

    Google Scholar 

  17. Brun A, Englund E (1986) A white matter disorder in dementia of the Alzheimer type: a patho-anatomical study. Ann Neurol 19: 253–262

    Google Scholar 

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Scarpelli, M., Salvolini, U., Diamanti, L. et al. MRI and pathological examination of post-mortem brains: the problem of white matter high signal areas. Neuroradiology 36, 393–398 (1994). https://doi.org/10.1007/BF00612126

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