18q− Syndrome: Brain MRI shows poor differentiation of gray and white matter on T2-weighted images

• Published in: Journal of magnetic resonance imaging Vol. 18; no. 4; pp. 414 - 419
• Main Authors: Linnankivi, Tarja T., Autti, Taina H., Pihko, S. Helena, Somer, Mirja S., Tienari, Pentti J., Wirtavuori, Kari O., Valanne, Leena K.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-10-2003
• Subjects: 18q− syndrome; Abnormalities, Multiple - genetics; Abnormalities, Multiple - pathology; Adolescent; Adult; Brain - pathology; Child; Child, Preschool; Chromosome Deletion; Chromosomes, Human, Pair 18 - genetics; dysmyelination; Female; Humans; Infant; Magnetic Resonance Imaging; Male; MRI; myelin basic protein; Myelin Basic Protein - genetics; white matter disorder
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.10383

Purpose
To study brain MRI findings in patients with 18q− syndrome and to correlate these findings with the results of the molecular breakpoint analysis.
Materials and Methods
Brain MR images of 17 patients with 18q− syndrome were evaluated. Segregation analysis was performed with 15 microsatellite markers to determine the deletion breakpoints and whether the deletion included the myelin basic protein (MBP) gene.
Results
One patient had an interstitial deletion of 18q which spared the MBP gene. He was the only one with normal brain MRI. All 16 patients with deletions including the MBP gene had abnormal white matter in MRI. The main finding was poor differentiation of gray and white matter on T2‐weighted images due to increased white matter signal intensity. In addition, measured signal intensity of the white matter was significantly increased in patients compared with controls.
Conclusions
Poor differentiation of gray and white matter on T2‐weighted images is the most typical MRI finding of the 18q− syndrome. These results support the postulation that abnormal myelination in 18q− syndrome is due to haploinsufficiency at or near the MBP locus. J. Magn. Reson. Imaging 2003;18:414–419. © 2003 Wiley‐Liss, Inc.