RADIOLOGICAL CHANGES IN MRI IMAGING OF PARKINSONIAN SYNDROMES

Reem Salem*, Ruba Shahin, Ziad Bitar and Khalid Khattab

ABSTRACT

Background:
Parkinsonian syndromes are neurodegenerative disorders with overlapping motor features, making
early diagnosis challenging. MRI offers non invasive radiological markers that can aid differential diag nosis.
Methods and Material s: We conducted a retrospective descriptive study at Al Mouwasat University Hospital
(2020 2024), including 98 patients clinically diagnosed with Parkinson’s disease or related syndromes who
underwent brain MRI using 1.5 Tesla ma chines. Data were reviewed from PACS with radiological oversight.
Results: The cohort was predominantly male (65%) with most patients aged 60 70 years (90%). Tremor (86%) and
postural instability (75%) were the most frequent symptoms. MRI revealed white matter hyperintensities in 95%,
absence of the swallow tail sign in 79%, and substantia nigra signal loss in 77%. Elevated red nucleus signal was
observed in 76%. The hot cross bun sign appeared in 43%, and cortical atrophy was present in 67%, with additional
subcortical (23%), cerebellar (5%), and basal ganglia (3%) atrop hy. Conclusion: MRI findings in this study mirror
global trends in PD imaging. The frequent detection of atypical signs suggests a need for careful radiological
assessment to improve diagnostic precision.

Keywords: Parkinsonian syndromes, MRI, Swallow tai l sign, Hot cross bun sign.