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Cerebellar Lesions in Multiple System Atrophy: Postmortem MR Imaging-Pathologic Correlations

Cerebellar Lesions in Multiple System Atrophy: Postmortem MR Imaging-Pathologic Correlations This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1662v1 30/9/1725 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Matsusue, E. Articles by Ogawa, T. Search for Related Content PubMed PubMed Citation Articles by Matsusue, E. Articles by Ogawa, T. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 30:1725-1730, October 2009 © 2009 American Society of Neuroradiology BRAIN Cerebellar Lesions in Multiple System Atrophy: Postmortem MR Imaging–Pathologic Correlations E. Matsusue a , S. Fujii a , Y. Kanasaki a , T. Kaminou a , E. Ohama b and T. Ogawa a a From the Division of Radiology (E.M., S.F., Y.K., T.K., T.O.), Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan b Department of Neuropathology (E.O.), Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan. Please address correspondence to Eiji Matsusue, MD, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University. 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan; e-mail: matsusue@grape.med.tottori-u.ac.jp BACKGROUND AND PURPOSE: Cerebellar atrophy and white matter T2-hyperintensities have been characterized as cerebellar lesions of multiple system atrophy (MSA). The aim of the study was to correlate MR images with histologic findings in cerebellar lesions of MSA. MATERIALS AND METHODS: Postmortem T2-weighted images using 1.5T were compared with histologic findings in 7 postmortem-proved cases with MSA. The MR imaging findings in the cerebellar cortices and deep white matter dentate nucleus regions were compared with their histologic findings in each case. RESULTS: We detected 3 types of cerebellar changes: type 1, no apparent atrophy or signal-intensity changes; type 2, cerebellar atrophy and inhomogeneous (patchy and/or confluent) cerebellar white matter hyperintensities; and type 3, cerebellar atrophy and diffuse white matter hyperintensities. Hypointensities were seen in the dentate nucleus regions. Atrophy of the cerebellar white matter was more severe than that of cerebellar cortices, and this anatomy was well depicted on coronal images. Histologically, degeneration was more severe in the cerebellar white matter than in the cerebellar cortices. Hyperintensities in the cerebellar white matter showed loss of myelinated fibers and gliosis. Hypointensities in the dentate nucleus regions revealed diffuse ferritin deposition in preserved dentate nuclei and white matter both around and within the nuclei. CONCLUSIONS: Hyperintensities in the cerebellar white matter reflect degenerated white matter associated with loss of myelinated fibers and gliosis, whereas hypointensities in the dentate nucleus regions reflect diffuse ferritin deposition in preserved dentate nuclei and white matter around and within the nuclei. Degeneration is more severe in the cerebellar white matter than in the cerebellar cortices. Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Cerebellar Lesions in Multiple System Atrophy: Postmortem MR Imaging-Pathologic Correlations

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A1662
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1662v1 30/9/1725 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Matsusue, E. Articles by Ogawa, T. Search for Related Content PubMed PubMed Citation Articles by Matsusue, E. Articles by Ogawa, T. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 30:1725-1730, October 2009 © 2009 American Society of Neuroradiology BRAIN Cerebellar Lesions in Multiple System Atrophy: Postmortem MR Imaging–Pathologic Correlations E. Matsusue a , S. Fujii a , Y. Kanasaki a , T. Kaminou a , E. Ohama b and T. Ogawa a a From the Division of Radiology (E.M., S.F., Y.K., T.K., T.O.), Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan b Department of Neuropathology (E.O.), Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan. Please address correspondence to Eiji Matsusue, MD, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University. 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan; e-mail: matsusue@grape.med.tottori-u.ac.jp BACKGROUND AND PURPOSE: Cerebellar atrophy and white matter T2-hyperintensities have been characterized as cerebellar lesions of multiple system atrophy (MSA). The aim of the study was to correlate MR images with histologic findings in cerebellar lesions of MSA. MATERIALS AND METHODS: Postmortem T2-weighted images using 1.5T were compared with histologic findings in 7 postmortem-proved cases with MSA. The MR imaging findings in the cerebellar cortices and deep white matter dentate nucleus regions were compared with their histologic findings in each case. RESULTS: We detected 3 types of cerebellar changes: type 1, no apparent atrophy or signal-intensity changes; type 2, cerebellar atrophy and inhomogeneous (patchy and/or confluent) cerebellar white matter hyperintensities; and type 3, cerebellar atrophy and diffuse white matter hyperintensities. Hypointensities were seen in the dentate nucleus regions. Atrophy of the cerebellar white matter was more severe than that of cerebellar cortices, and this anatomy was well depicted on coronal images. Histologically, degeneration was more severe in the cerebellar white matter than in the cerebellar cortices. Hyperintensities in the cerebellar white matter showed loss of myelinated fibers and gliosis. Hypointensities in the dentate nucleus regions revealed diffuse ferritin deposition in preserved dentate nuclei and white matter both around and within the nuclei. CONCLUSIONS: Hyperintensities in the cerebellar white matter reflect degenerated white matter associated with loss of myelinated fibers and gliosis, whereas hypointensities in the dentate nucleus regions reflect diffuse ferritin deposition in preserved dentate nuclei and white matter around and within the nuclei. Degeneration is more severe in the cerebellar white matter than in the cerebellar cortices. Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Oct 1, 2009

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