Decreased T1 contrast between gray matter and normal-appearing white matter in CADASIL.

[cadasil]

CADASIL is the most frequent hereditary small -vessel disease of the brain . The clinical impact of various MR imaging markers has been repeatedly studied in this disorder , but alterations of contrast between gray matter and normal-appearing white matter remain unknown . The aim of this study was to evaluate the contrast alterations between gray matter and normal-appearing white matter on T 1 -weighted images in patients with CADASIL compared with healthy subjects .Contrast between gray matter and normal-appearing white matter was assessed by using histogram analyses of 3 D T 1 high -resolution MR imaging in 23 patients with CADASIL at the initial stage of the disease (Mini-Mental State Examination score > 24 and modified Rankin scale score ≤ 1 ; mean age , 53 .5 ± 11 .1 years ) and 30 age- and sex-matched controls .T 1 contrast between gray matter and normal-appearing white matter was significantly reduced in patients compared with age- and sex-matched controls (patients : 1 .35 ± 0 .08 versus controls : 1 .43 ± 0 .04 , P < 10 (-5 )). This reduction was mainly driven by a signal decrease in normal-appearing white matter . Contrast loss was strongly related to the volume of white matter hyperintensities .Conventional 3 D T 1 imaging shows significant loss of contrast between gray matter and normal-appearing white matter in CADASIL . This probably reflects tissue changes in normal-appearing white matter outside signal abnormalities on T 2 or FLAIR sequences . These contrast alterations should be taken into account for image interpretation and postprocessing .