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T2 Hyperintensity of Medial Lemniscus: Higher Threshold Application to ROI Measurements is More Accurate in Predicting Small Vessel Disease
Author(s) -
Hakky Michael M.,
Erbay Kaan D.,
Brewer Edward,
Midle Jennifer B.,
French Robert,
Erbay Sami H.
Publication year - 2013
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12011
Subject(s) - medicine , region of interest , medial lemniscus , hyperintensity , false positive paradox , fluid attenuated inversion recovery , lateral lemniscus , nuclear medicine , radiology , magnetic resonance imaging , artificial intelligence , inferior colliculus , nucleus , psychiatry , computer science , thalamus
BACKGROUND Medial lemniscus T2 hyperintensity (MLH) has been recently demonstrated as potential imaging marker for small vessel disease (SVD). Our purpose in this study is to improve accuracy of regions of interest (ROI) analysis for this imaging finding. METHODS AND METHODS Two neuroradiologists retrospectively reviewed 103 consecutive outpatient brain MRI. Medial lemniscus signal in dorsal pons was evaluated; visually on FLAIR and with ROI on T2. Original MRI interpretations were divided into three categories; SVD, multiple sclerosis (MS), and nonspecific WM changes (non). RESULTS Thirty‐seven patients had SVD, 14 patients had MS, 52 had Non. Visual MLH was seen exclusively with SVD and was generally bilateral. Patients with visual MLH belonged to advanced SVD by imaging and clinical parameters. Compared to visual data, ROI analyses of MLH has been known to be compounded by false positives and negatives at low threshold (20% of adjacent to normal brainstem signal). With application of higher ROI threshold (25%), false positives were eliminated but false negatives increased. ROI analyses of MLH by experienced neuroradiologist were more reliable. CONCLUSION MLH seen on high threshold ROI analysis is a reliable radiologic marker in predicting SVD. ROI analysis of MLH should be performed by an experienced neuroradiologist.