PURPOSE: To determine whether decreased signal intensity of the motor
cortex (T2 shortening) at magnetic resonance (MR) imaging is a useful
finding for supporting the diagnosis of amyotrophic lateral sclerosis
(ALS). MATERIALS AND METHODS: High-field-strength (1.5-T) MR images of
15 patients (seven men and eight women, aged 28-80 years) and 49 neur
ologically normal age-matched control patients were examined for T2 sh
ortening in the motor cortex. In addition, brains of patients with ALS
were examined at autopsy. RESULTS: The MR images of 14 of the 15 pati
ents showed T2 shortening in precentral cortices, while the images of
all but one of the control patients showed no such finding. In three o
f eight brains at autopsy, sections from the precentral cortex showed
sparsely distributed, intensely stained astrocytes and macrophages. CO
NCLUSION: Abnormal iron deposition associated with the degenerative pr
ocess could be the source of T2 shortening, which is a useful MR imagi
ng finding in the diagnosis of ALS.