 Myself, Dr. Latha, junior resident department of radio diagnosis in Dr. D. Vipadal Medical College. My topic for paper presentation is evaluation of Nigrosome 1 in a clinically suspected cases of Parkinson's on 3-Tesla MRI under the guidance of Dr. Rajesh Kuber, professor and Dr. Nair LaKrishna Teja, assistant professor. He means to assess the imaging features of Nigrosome 1 in the substance here, Nigra through 3-T-weighted, susceptibility-weighted imaging and its disease-specific changes for diagnosis of Parkinson's disease. Coming to the interruption, Parkinson's Nigra is a grimace that lies in the cerebral peduncle between the crust cerebrae and tegmentum of the mid-brain at the level of superior coli. It has two parts, superficial zona reticulata and deep part zona compacta. Coming to the Nigrosome, it's a small cluster of dopamurgic cells within the substance here, Nigra that exhibit the calypidinum D28K negativity on histochemistry, immuno-histochemistry, fine Nigrosome measures up to 5 mm in size and have been described with the largest labelled as Nigrosome 1. It is located in the posterior third of the substance here, Nigra returns a high signal on the high-resolution T2 star or SWI in a linear coma or with shape. It is surrounded by a low SWI signal intensity anterior and laterally pars compacta and medially by a low signal from the medial lemniscus, which resemble the distinctive splint tail of a swallow and hence it referred as a swallow tail appearance. Nigrosome 1 contains the largest proportion of neurons affected in Parkinson's disease, a condition that causes the high SWI signal within the Nigrosome 1 to be absent. Absence of a normal swallow tail appearance of a Nigrosome 1 is reported to be a reliable sign of Parkinson's disease. There are two main possible mechanisms for this. One is increased iron content or decreased neuromelanin content with decreased iron storage capability leading to more free iron with paramagnetic properties. Iron in the brain accumulates mainly as ferritin in the oligodendrocytes, but it can also be found in the neurons and microglia, as shown in the postmortem images, with higher concentration in the globus pallidus, substance here Nigra, red neocleus, caudate and putamen. In Parkinson's, the substance here Nigra iron content is increased as demonstrated by the several postmortem studies with high iron levels in the individual neuromelanin granules of the Nigral neurons. Coming to the anatomy, here is an axial midbrain section showing which red nucleus which is indicated by one and two being the tectile part of the midbrain and three is the aqueduct and four is the periaqueductal gramato. Five is the medial lemniscus and six is the nigrosomes, seven is the substance here Nigra. Here is the image showing the red rumped swallow, the tail of the red rumped swallow resemble the appearance of healthy Nigrosome on the susceptibility weighted imaging of MRI. But the loss of this functional Nigral Neural early in the course of this is results in the general decrease in number of neuromelanin granules with iron being sequestrated in the levy bodies in substance here Nigra past compact neurons and with an increased loading of ferritin with iron. MR advanced sequences in hyphil magnets open the possibility to visualize in vivo the substance here Nigra and to investigate the specific pathological changes enabling the development of high accuracy tools for disease diagnosis in early stage. Our work was centered on the application of MR imaging technique to study the substance here Nigra in Parkinson's disease early in the disease course mainly focusing on untreated patients at the time of clinical diagnosis. Here we investigated the feasibility of Nigrosome one detection using 3D susceptibility weighted MRI and the diagnostic accuracy that can be achieved for diagnosing Parkinson's in a clinical population. Coming to the materials and methods place of studies Dr. D. Vipartal Medical College and Hospital Pimprey Pune type of study is observational study of took over the period of two years from September 2019 to August 2021 and method of diagnosis is MRI in a 3 Tesla. Coming to the image inclusion criteria patients with clinical suspicion of Parkinson's disease and the exclusion being criteria being claustrophobic metallic foreign body in C2 patients less than the age of 30 years. Coming to the imaging protocol study subjects were evaluated on 3 Tesla Vida MRI scanner with susceptibility weighted imaging focused on brainstem with factors T being 24.9 and TR being 36.4 flip angle is 10 degrees slice thickness is 1.4 mm bandwidth is 62 to 5 acquisition time being 5 minutes 40 seconds informed consent and written consent was obtained from all the patient included in the study. Coming to the imaging analysis presence of a swallowtail or Nigrosome one was rated for each heme megaline sephalon heme meson sephalon at the level of caudal posterior substance in nigra on axial images. Nigrosome one scores were allotted based on the presence of absence because of the asymmetrical onset of the Parkinson's unilateral absence of Nigrosome one was classified as an indicative of Parkinson's irrespective of the presence of absence of Nigrosome one on either side. The width of the radial line at its widest point of the droplet is taken as point as a and in corresponding middle layer width of substance in nigra is taken as B and the ratio of A and B were taken in controls and the thin banded high signal intensity at the widest point is taken as C and in corresponding layer of middle width of substance nigra was taken as B and its ratio was taken B by C in cases or in control in cases. Coming to the statistical analysis done using chi-square test measurable data ABC were presented by mean and standard deviation and the p-value is less than 0.05 was considered statistically significant and coming to the results the signals of Nigrosome one were strong droplet or oval were found in 26 patients from NPD group on both sides of the substantia nigra and unilaterally in two cases and invisible in both the sides in two cases. In contrast these signals were absent in 29 clinically suspected cases and one case with a typically typical hyper intensity were clinically proven to be Parkinson's plus syndrome. The results were 0.001 the result is statistically significant if the p-value is 0.005. Coming to the imagers here is a 49 years old female patient control axial SWI image showing high signal Nigrosomes in the substantia nigra which is indicated with the blue arrows. Here is a same age group clinically suspected Parkinson's patient showing absence of high signal in the substantia nigra on either sides. Here is a MR axial image of the SWI sequence showing the 70 years old male who is a control axial image showing high signal Nigrosome one in the substantia nigra in the left side indicated with the green arrow in a clinically suspected case with corresponding age shows absence of high signal in the substantia nigra on either sides. Coming to the age distribution here is a pi diagram of the age distribution showing various age groups predominantly involving 52 60 years age group and here is a bar diagram showing sex distribution which is predominantly involving the male sex. Coming to the analysis of Nigrosome one here is a tabular column for the analysis of Nigrosome one with the cases and control in which one case showed unilateral bilateral visible Nigrosomes signal and the 26 control had unilateral and bilateral visible Nigrosome signal. Coming to the and 29 cases show had absent Nigrosome signal in the unilateral and bilateral sites. Coming to the control four had four controls had absent unilateral bilateral Nigrosome one signal. Sensitivity being 87.8% specificity is 96.3% coming to the accuracy it is 91.6%. Coming to the substantia nigra thickness is a tabular form showing thickness of the substantia nigra. So the age group of 30 to 50 years the cases of 30 to 50 years had increased substantia nigra thickness whereas 50 to 70 and 72 90 years age group had the thickness of substantia nigra was equal almost equal in the cases as well as control. Coming to the discussion Parkinson's is a common neurodegenerative disorder among middle age resulting from degenerate degeneration of dopamirgic neurons in the substantia nigra of midbrain. MR susceptibility weighted technique uses the information of magnetic susceptibility differences between region generate image contrast combining both magnitude and phase information and although not allowing the quantification is very sensitive to alterations included by the presence of paramagnetic substance such as iron. Other study showed several important findings on the axial SW image magnitude imaging the substantia nigra parts compact of other of those non Parkinson's corresponds to the feature high signal in the Nigrosomes one which is most likely droplets. The average width at its widest point of the oval high signal is about 1.5 plus or minus 0.54 mm and its average ratio with its width in the middle of the substantia nigra in the corresponding layer is about 0.31 plus or minus 0.07 mm. The absence of high signal is used to evaluate the sensitivity and specificity in the Parkinson's diagnosis which is 96.6 percent and around 86.67 percent respectively in our study. In our study there is no difference in the thickness of substantia nigra in cases control and with age progression the absence of typical Nigrosome one signal in 3 tesla MR susceptibility weighted image may be useful in identifying Parkinson's disease with high sensitivity and specificity. These are the references. Thank you.