Swallow Tail Sign: Revisited

Brammerloh, Malte; Kirilina, Evgeniya; Alkemade, Anneke; Bazin, Pierre-Louis; Jantzen, Caroline; Jäger, Carsten; Herrler, Andreas; Pine, Kerrin J.; Gowland, Penny A.; Morawski, Markus; Forstmann, Birte U.; Weiskopf, Nikolaus

Abstract

The loss of the radiologic swallow tail sign on MRI scans of the substantia nigra is a promising diagnostic marker of Parkinson disease (1), although its anatom-ic underpinning is unclear. An early influential study showed that the hyperintense inner part of the swallow tail sign on T2*-weighted images (STh) corresponds to iron-poor areas in substantia nigra and suggested it to equal nigrosome 1, the dopaminergic region affected earliest and strongest in Parkinson disease (2). This would render the STh a cellularly specific marker (2). However, recent postmortem tissue studies have chal-lenged this interpretation, reporting that nigrosome 1 is hypointense in T2*-weighted images (3,4). We com-bined three-dimensional histology with 7-T in vivo and postmortem MRI to demonstrate that nigrosome 1 and the radiologic STh are partially overlapping but distinct.

• Journal Article Type: Article
• Acceptance Date: Jun 6, 2022
• Online Publication Date: Aug 16, 2022
• Publication Date: Dec 1, 2022
• Deposit Date: Aug 20, 2022
• Publicly Available Date: Aug 23, 2022
• Journal: Radiology
• Print ISSN: 0033-8419
• Electronic ISSN: 1527-1315
• Publisher: Radiological Society of North America (RSNA)
• Peer Reviewed: Peer Reviewed
• Volume: 305
• Issue: 3
• Pages: 674-677
• DOI: https://doi.org/10.1148/radiol.212696
• Keywords: Radiology, medical physics, neuroscience, neurology, MRI
• Public URL: https://nottingham-repository.worktribe.com/output/10082995
• Publisher URL: https://pubs.rsna.org/doi/10.1148/radiol.212696