[Hyperintense punctiform images in the white matter: a diagnostic approach]

Radiologia. 2012 Jul-Aug;54(4):321-35. doi: 10.1016/j.rx.2011.09.015. Epub 2012 Jan 28.
[Article in Spanish]


The presence of hyperintense punctiform images in the white matter in T2 weighted magnetic resonance (MR) sequences is a very common finding and is occasionally a diagnostic challenge for the radiologist. The present article attempts, using an anatomical approach to the brain circulation, as well as from histopathology correlation studies, to simplify the task of interpreting these images from the description of the three main patterns of hyperintense punctiform images in the white matter: vascular pattern, which corresponds to microvascular lesions; perivascular pattern, which represents inflammatory disease of which the paradigm is multiple sclerosis; and a non-specific pattern, which has to be a microvascular disease. From the various semiological elements in the MR images, a predominant pattern can be determined in each case and, in this way, helps in the differential diagnosis.

Publication types

  • English Abstract

MeSH terms

  • Algorithms
  • Brain Diseases / pathology*
  • Brain Diseases / physiopathology
  • Cerebrovascular Circulation
  • Diagnosis, Differential
  • Humans
  • Leukoencephalopathies / pathology*
  • Leukoencephalopathies / physiopathology
  • Magnetic Resonance Imaging*
  • Neuroimaging*