Abstract
BackgroundThe specific periaqueductal gray (PAG) lesions with migraine-like headache were easily identified on conventional MR images in clinical practice, and the aim of this study is to investigate the nonspecific periaqueductal gray (PAG) lesions in episodic migraine (EM) patients based on T2 weighted imaging (T2WI).MethodsT2WI images were obtained from 18 EM patients and 18 normal controls (NC) on 3.0 T MR system. The images were observed by two experienced radiologists, and the lesions were identified on T2WI by consensus by 2 experienced neuroradiologists blinded to the patient identity. Chi-Square test was performed for the significance test.ResultsRing-like hyperintensity lesions (HILs) around the PAG region were observed in 14 EM patients and in 5 NCs on T2WI. Four EM patients and 13 NCs were normal in PAG region. The significance was revealed by Chi-Square test (P = 0.003).ConclusionHIL of PAG may be the direct evidence of the EM genesis, and the further structural and functional study should be performed to elucidate the neuromechanism of migraine pathogenesis.
Highlights
The specific periaqueductal gray (PAG) lesions with migraine-like headache were identified on conventional MR images in clinical practice, and the aim of this study is to investigate the nonspecific periaqueductal gray (PAG) lesions in episodic migraine (EM) patients based on T2 weighted imaging (T2WI)
PAG dysfunction was recognized in migraine [3], and the PAG dysfunction may be associated with iron deposition and may be considered as a possible “generator” of migraine attacks [1, 4, 5]
Brain T2visible hyperintensity lesions commonly presented in migraine patients [12, 13], and these T2 lesions may be seen in gray matter, and commonly located in white matter
Summary
The specific periaqueductal gray (PAG) lesions with migraine-like headache were identified on conventional MR images in clinical practice, and the aim of this study is to investigate the nonspecific periaqueductal gray (PAG) lesions in episodic migraine (EM) patients based on T2 weighted imaging (T2WI). The PAG lesions with migraine-like headache were mainly identified in multiple sclerosis [6,7,8,9,10] and infarction [11]. These lesions could be considered as specific lesions because of definite clinical diagnosis. Compared with the previous reported specific lesions, the T2-visible lesions could be called as nonspecific lesions
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