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KMID : 0359719960140010215
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Journal of the Korean Neurological Association
1996 Volume.14 No. 1 p.215 ~ p.222
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Magnetic Resonance Imaging of Brain in Amyotrophic Lateral Sclerosis
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서대원/Seo, D.W.
나정호/이광우/노재규/이상복/장기현/La, J.H./Lee, K.W./Roh, J.K./Lee, S.B./Chang, G.H.
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Abstract
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To visualize upper motor neuron (UMN) lesions in amyotrophic lateral sclerosis (ALS), brain magnetic resonance imaging (MRI) was performed in 14 patients with ALS. In all patients, ALS was confirmed on the basis of clinical, electrophysiologic, and pathologic findings. We reviewed T2 and proton-weighted axial images of the brain at six levels: corona radiata (CR) , upper internal capsule(UIC), lower internal capsule (LIC), cerebral peduncle(CP), basis pontis (BP), and pyramid (PR) level. T2 and proton-weighted images at each level were analyzed by neuroradiologist and neurologist. We also compared clinical findings between hypersignal and no-signal groups in correlation with deep tendon reflexes and pathologic reflexes.
T2-weighted images showed high signal intensities at more than two levels along the course of pyramidal tract from corona radiata through medulla in 7 patients. In 3 patients, proton-weighted image revealed high signal intensities corresponding to abnormalities on T2-weighted image. These high signal intensities were observed at the level of LIC in 7 patients, at CP in 6, UIC in 5, BP in 3, PR in 2. There was no significant difference in pathologic reflexes although hypersignal group was more frequently involved than no-signal group (p>0. 05) . Regarding deep tendon reflexes, hypersignal group was significantly more hyperreflexic than no-signal group (p=0.005).
In conclusion, MRI in ALS patients can show hyperintensities on axial T2-weighted images, and these findings were better seen at the level of lower internal capsule. The patients with hyperintensities had more conspicuous upper motor neuron signs than the patients without hyperintensities. These abnormalities may suggest more severe involvement and degeneration of the UMNs in ALS patients.
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