Identification of the primary motor cortex: value of T2 echo-planar imaging, diffusion-weighted imaging and quantitative apparent diffusion coefficient measurement at 3 T. European radiology [Eur Radiol] Journal article

OBJECTIVES: To investigate the primary motor cortex (PMC) concerning T2 shortening on T2 echo-planar imaging (EPI-T2) and the double-layer sign on diffusion-weighted imaging (DWI), and also to measure its apparent diffusion coefficient (ADC).
METHODS: 3-T MR DWI was performed in 134 adult volunteers and 64 patients. T2 shortening was graded as hypointense or isointense compared with the signal of the superior frontal cortex (SFC). The double-layer sign of the PMC was graded as present or absent. Both findings (T2 shortening and double-layer sign) were evaluated independently by two authors. ADC of the PMC and the SFC were calculated using manually selected ROIs.
RESULTS: T2 shortening was found in 131 adults and 62 patients by author 1 and in 132 adults and 61 patients by author 2 (kappa = 0.96 and 0.91). The double-layer sign was found in 131 adults and 61 patients by author 1 and in 127 adults and 58 patients by author 2 (kappa = 0.94 and 0.91). ADC values of the PMC and the SFC were different for all subjects (p < 0.01).
CONCLUSIONS: T2 shortening and/or the double-layer sign on 3-T MR can be used to locate the PMC. The difference in ADC values between PMC and SFC is a distinguishing feature.

European radiology [Eur Radiol]