Objective To analyze slit-like putaminal hypointensity on T2-weighted imaging, and putaminal hypointensity on DWI,pontine atrophy and middle cerebellar peduncle atrophy in patients with multiple system atrophy-parkinsonian type(MSA-P). Methods Twenty patients with MSA-P and another 20 age-matched healthy subjects were enrolled. The scanning protocol included FSE T2WI sequences on standard sagittal and axial views,T1 FLAIR sequence on the axial view,and diffusion weighted imaging(DWI) sequence on the axial view. Atrophy of the pons and middle cerebellar peduncle,slit-like putaminal hypointensity on T2-weighted imaging,and putaminal hypointensity on DWI were all evaluated. Results Puaminal hypointensity on DWI was observed in 90%(18/20)of the patients,slit-like putaminal hypointensity on T2-weighted imaging in 70% (14/20), unilateral or bilateral middle cerebellar peduncle atrophy in 40%(8/20),and pontine atrophy in 30%(6/20).The slit-like putaminal hypointensity on T2-weighted imaging and putaminal hypointensity on DWI were significantly different between MSA-P patients and controls (P＜0.01). Conclusions The slit-like putaminal hypointensity on T2-weighted imaging and putaminal hypointensity on DWI are more common among MSA-P patients. The incidence of putaminal hypointensity on DWI is higher than that of slit-like putaminal hypointensity on T2-weighted imaging in patients with MSA-P.
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