Paradoxical paramagnetic calcifications in the globus pallidus: An ex vivo MR investigation and histological validation study

• Published in: NMR in biomedicine 2021-10, Vol.34 (10), p.e4571-n/a
• Main Authors: Jang, Jinhee, Nam, Yoonho, Jung, Sung Won, Riew, Tae‐Ryong, Kim, Sang Hyun, Kim, In‐Beom
• Format: Article
• Language: English
• Subjects: Aged; Arteries; Basal Ganglia - diagnostic imaging; Basal Ganglia - pathology; Biological products; Calcinosis - diagnostic imaging; Calcium; calcium, ex vivo, histology, iron, quantitative susceptibility mapping; Computed tomography; Degeneration; Deposition; Female; Globus pallidus; Globus Pallidus - diagnostic imaging; Globus Pallidus - pathology; Humans; Image contrast; Iron; Magnetic Resonance Imaging; Male; Medical imaging; Metabolism; Neurodegeneration; Perforating; Phase contrast; Putamen; Tomography, X-Ray Computed
• ISSN: 0952-3480; 1099-1492
• DOI: 10.1002/nbm.4571

MR images based on phase contrast images have gained clinical interest as an in vivo tool for assessing anatomical and histological findings. The globus pallidus is an area of major iron metabolism and storage in the brain tissue. Calcium, another important metal in the body, is frequently deposited in the globus pallidus as well. Recently, we observed dense paramagnetic deposition with paradoxical calcifications in the globus pallidus and putamen. In this work, we explore detailed MR findings on these structures, and the histological source of the related findings using ex vivo CT and MR images. Ex vivo MR was obtained with a maximum 100 μm3 isotropic resolution using a 15.2 T MR system. 3D gradient echo images and quantitative susceptibility mapping were used because of their good sensitivity to metallic deposition, high signal‐to‐noise ratio, and excellent contrast to iron and calcium. We found dense paramagnetic deposition along the perforating arteries in the globus pallidus. This paramagnetic deposition was hyperdense on ex vivo CT scans. Histological studies confirmed this finding, and simultaneous deposition of iron and calcium, although more iron dominant, was observed along the vessel walls of the globus pallidus. This was an exclusive finding for the penetrating arteries of the globus pallidus. Thus, our results suggest that several strong and paradoxical paramagnetic sources at the globus pallidus can be associated with vascular degeneration. We explored detailed ex vivo image findings of paradoxical paramagnetic structures in the globus pallidus, and the histological sources of these findings. We found dense simultaneous iron and calcium deposition along the perforating arteries of the globus pallidus. Our findings reveal that strong and paradoxical paramagnetic sources occasionally found in the globus pallidus are associated with vascular degeneration.