The spectrum of subcortical lesions in MRI, sensitivity and specificity

  • M. Forsting
  • W. Hacke
  • K. Sartor
Part of the Journal of Neural Transmission book series (NEURAL SUPPL, volume 33)


Subcortical foci of increased signal intensity are frequently identified on MRI in the elderly. The lesions are compatible with various pathologic processes and MRI can only provide supportive data for a suspected diagnosis. Without the patient’s clinical history the radiologist is not able to differentiate between real pathologic lesions and physiologic aging processes. The high sensitivity of MRI in detecting white matter lesions and the lack of specificity recommands an excellent teamwork between clinicians and radiologists.

Magnetic resonance imaging increasingly used as a diagnostic modality, is highly sensitive to subtle changes of the subcortical brain parenchyma accompany a wide variety of neurologic disorders. While some of these white matter lesions occur in conjunction with known or suspected neurologic disease, others are unexpected or incidental. The question remains whether these latter changes represent early forms of occult neurologic disease or normal physiologic processes. To avoid pathologic or etiologic presumptions, Hachinski et al. (1987) suggested the term leuko-araiosis (LA) to denote areas of decreased attenuation on CT or increased intensity on T2 — weighted MR images.

The goal of this paper is to briefly review the literature regarding the sensitivity and specificity of white matter hyperintensities in T2 — weighted MR images, and to illustrate the problems of interpretation of these lesions in elderly patients.


White Matter White Matter Lesion Cerebral Amyloid Angiopathy White Matter Hyperintensities Increase Signal Intensity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • M. Forsting
    • 2
  • W. Hacke
    • 3
  • K. Sartor
    • 1
  1. 1.Departments of NeuroradiologyUniversity of HeidelbergFederal Republic of Germany
  2. 2.Department of NeuroradiologyHeidelbergFederal Republic of Germany
  3. 3.Departments of NeurologyUniversity of HeidelbergFederal Republic of Germany

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