Introduction: In the past decade, major advances in magnetic resonance imaging (MRI) have changed the in vivo evaluation of parkinsonian syndromes, with a growingly important role in individual patient evaluation and pathophysiological characterization. Recent innovations in imaging techniques, including advanced sequences at high and ultrahigh field MRI and modern image analysis algorithms, have enabled visualization of structural and functional brain changes in Parkinson’s disease (PD), as well as atypical parkinsonian disorders (APD), arising as important tools to improve sensitivity and specificity of clinical diagnosis, monitor therapeutic interventions and study the progression of the disease. 
 
 Method: We reviewed PD imaging advances and suggest a standardized PD MRI protocol for use in clinical settings. 
 
 Result and Conclusion: New MRI sequences, particularly those allowing neuromelanin and brain iron visualization, as well as quantitative brain volume measurements techniques, have been shown to be accurate tools for PD evaluation, even in early disease stages, and for differential diagnosis with other parkinsonian syndromes. A multimodal MRI approach of combinations of different methods and techniques sensitive to complementary tissue characteristics may provide higher diagnostic accuracy than single methods and techniques. However, current heterogeneity of MRI studies interferes with the quality of the reports and data collected with implications for the quality of care. Standardization will allow for a better and more homogeneous collection of data for image repositories and for research purposes. It is therefore important to adopt a standardized MRI protocol for the study of parkinsonian syndromes.

A STANDARDIZED MR IMAGING PROTOCOL FOR PARKINSONISM