RESEARCH: Characteristic MRI findings in multiple system atrophy

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Neuroradiology 2002 Mar;44(3):204-9

Characteristic MRI findings in multiple system atrophy: comparison of the

three subtypes.

Naka H, Ohshita T, Murata Y, Imon Y, Mimori Y, Nakamura S.

Third Department of Internal Medicine, Hiroshima University School of

Medicine, Japan. h.naka@...

We reviewed MRI findings in 29 patients with probable multiple system

atrophy (MSA) to see whether there were common and or less common

neuroradiological findings in the various clinical subtypes. We divided the

patients into three clinical subtypes according to initial and predominant

symptoms: 14 with olivopontocerebellar atrophy (OPCA), eight with the

Shy-Drager syndrome (SDS) and seven with striatonigral degeneration (SND).

The patients showed atrophy of the brain stem and cerebellum, high signal on

T2-weighted images of the base of the pons and middle cerebellar peduncles,

high and low signal on T2-weighted images of the putamen and atrophy of

frontal and parietal lobes. The degree of atrophy of the middle cerebellar

peduncle and cerebellum was greater in OPCA patients and a high-signal

lateral rim to the putamen more frequent in SND. However, all findings were

observed in all subtypes, and the degrees of atrophy of the putamen and pons

and the frequency of high signal in the base of the pons were similar in the

subtypes. We also found atrophy of the cerebral hemispheres, especially the

frontal and parietal lobes, but its degree was not significantly different

in the various subtypes. Our findings suggest that, although MSA can be

divided clinically into three subtypes, most of the features on MRI are

common and overlap in the subtypes, independently of the clinical

presentation.

PMID: 11942373 [PubMed - in process]