PURPOSE: To quantitatively evaluate by MRI brain atrophy and abnormal parenchymal signal intensity onT2-weighted spin echo image in alcoholics. MATERIALS AND METHODS: MRI of 24 alcoholic patients were retrospectively evaluated to measure brain atrophy (cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci) and abnormal high signal lesions of brain parenchyma onT2-weighted spin echo image, and were compared with age matched controls (n=29). The alcoholics and controls were divided into two age groups, younger (30 - 49 years) and older (50 - 72 years), and statistical analysis was then performed. Axial and sagittal T1- and T2-weighted spin echo images were obtained using a 0.5 Tesla superconductive system. RESULTS: Statistical significant parameters in the supratentorial region were cerebral sulcal width, distance between lateral ends of frontal horns of both lateral ventricles, and third ventricular width (p<0.05),and in the infratentorial region were fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05). In the younger age group, statistical significant parameters were cerebral sulcal width, third ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05) and in the older group were cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, number of cerebellar sulci, and number of vermian sulci (p<0.05). Abnormal high signal intensity onT2-weighted spin echo images were seen in 46% of alcoholics (11/24) and in 13% of controls (3/29). High signal lesions in the older group were statistically significant (p<0.05). CONCLUSION: Atrophic brain changes and periventricular high signal foci on T2-weighted spin echo image are significantly higher in chronic alcoholics than in age-matched normal controls.