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Pathologic findings of silent, small hyperintense foci in the basal ganglia and thalamus on MRI

From the Department of Neurology (Drs. Takao, Koto, Tanahashi, and Fukuuchi), School of Medicine, Keio University, and the Departments of Neurology and Pathology (Drs. Takagi and Morinaga), Tokyo Saiseikai Central Hospital, Japan.

Address correspondence to Dr. Masaki Takao, Department of Neurology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

We analyzed the pathologic features of silent, small hyperintense foci in the basal ganglia and thalamus on MRI T2-weighted images (T2WI). Eight foci were histologically lacunar infarcts (LI), and 21 were dilated perivascular spaces (DPS). The foci with smooth margins were mostly DPS, whereas those with irregular margins were mostly LI (p = 0.018). Most putaminal foci were DPS, whereas most thalamic foci were LI (p = 0.001). The mean areas of LI and DPS overlapped below 19.6 mm². The shape and site of hyperintense foci on T2WI are important for differentiating LI from DPS.

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