Multiple system atrophy (MSA-P)

Discussion:

The putaminal rim sign on 1.5 T MRI is useful if present but the sign is not reliable on 3 T as it can be observed in normal individuals. 

Using the differential darkness of, and between, the putamina, globi pallidi, and red nuclei can be difficult - becoming familiar with one's own machine and GRE/SWI images in various age groups is a good start.

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