Relevance of non-specific MRI features in multiple system atrophy

Clinical Neurology and Neurosurgery
Sunil Pradhan, Ruchika Tandon

Abstract

Rarity of specific MRI features like 'hot-cross bun' sign and 'hyperintense putamen rim' reduce diagnostic utility of MRI in MSA. We therefore, studied some non-specific MRI features in addition to the specific ones, to find their diagnostic utility. Clinical and MRI features of 53 indoor and outdoor patients with MSA were analyzed in the context of its Parkinsonian (MSA-P) and cerebellar (MSA-C) variants. Of 53 cases (mean age: 59.53±9.74years), 16 (30.2%) had MSA-C and 37 (69.8%) had MSA-P. Midbrain atrophy was found in 37 (69.8%) MSA patients (70.3% of MSA-P and 68.8% of MSA-C), cerebellar atrophy in 45 (84.9%) MSA patients (81.1% of MSA-P and 93.8% of MSA-C), 'hot-cross bun' sign in 13 (24.5%) MSA patients (27% of MSA-P and 18.8% of MSA-C), hyperintense putamen rim in 19 (35.8%) MSA patients (37.8% of MSA-P and 31.3% of MSA-C) and corpus callosal atrophy in 39 (73.6%) MSA patients (75.7% of MSA-P and 68.8% MSA-C). The midbrain atrophy was mainly lateral tegmental and resembled a positive 'Morning glory' sign in 16 (30.2%). "Hot cross bun" sign and "hyperintense putamen rim" sign were rarely seen in MSA. Combination of mid brain atrophy, corpus callosum atrophy and cerebellar atrophy was more commonly observed in both MSA-C ...Continue Reading

Citations

Oct 7, 2017·Journal of Alzheimer's Disease : JAD·Kurt A Jellinger
Oct 13, 2017·Expert Review of Neurotherapeutics·Kurt A Jellinger
May 7, 2020·Movement Disorders Clinical Practice·Divyani GargKameshwar Prasad
Jun 30, 2019·Journal of Neurology·M PortetD C Howlett
Nov 17, 2020·Frontiers in Aging Neuroscience·Shuhua LiPu-Yeh Wu

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