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A Standardized Pipeline for Examining Human Cerebellar Grey Matter Morphometry using Structural Magnetic Resonance Imaging
Published on: February 4, 2022
MR imaging of middle cerebellar peduncle width: differentiation of multiple system atrophy from Parkinson disease
Giuseppe Nicoletti1, Francesco Fera, Francesca Condino
1Institute of Neurological Sciences, National Research Council, Mangone, Cosenza, Italy.
Purpose:
To prospectively assess if middle cerebellar peduncle (MCP) atrophy, evaluated at magnetic resonance (MR) imaging, can help differentiate multiple system atrophy (MSA) from Parkinson disease (PD).
Materials And Methods:
All participants provided informed consent for participation in the study, which was approved by the institutional review board. Sixteen consecutive patients with MSA, 26 consecutive patients with PD, and 14 healthy control subjects were examined with MR imaging. Images were interpreted independently by two experienced neuroradiologists blinded to clinical information, who visually inspected the images for the presence or absence of putaminal atrophy, putaminal hypointensity, slitlike hyperintensity in the posterolateral margin of the putamen, brainstem atrophy, hyperintensity of the MCP, and cruciform hyperintensity of the pons. Measurements of MCP width on T1-weighted volumetric spoiled gradient-echo images were performed in all subjects. Differences in MCP width among the groups were evaluated by using the Kruskall-Wallis test, followed by the Mann-Whitney U test for multiple comparisons and Bonferroni correction.
Results:
All patients (mean age, 63.88 years; range, 55-72 years) with MSA had at least one of the features commonly observed in this disease on MR images, whereas control subjects (mean age, 66.93 years; range, 61-77 years) and all but one patient with PD (mean age, 65.31 years; range, 51-79 years) had normal MR images. The average MCP width was significantly smaller in patients with MSA (6.10 mm+/-1.18 [standard deviation]) than in those with PD (9.32 mm+/-0.77, P<.001) or control subjects (9.80 mm+/-0.66, P<.001).
Conclusion:
Measurement of MCP width on MR images may be useful for distinguishing patients with MSA from those with PD.
Insights
Middle cerebellar peduncle (MCP) atrophy, identified via MRI, can help distinguish multiple system atrophy (MSA) from Parkinson disease (PD). Smaller MCP width in MSA patients suggests this measurement
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Differentiating multiple system atrophy (MSA) from Parkinson disease (PD) is clinically challenging due to overlapping symptoms.
- Magnetic resonance (MR) imaging features are crucial for diagnosing neurodegenerative disorders.
- Middle cerebellar peduncle (MCP) morphology may offer distinguishing characteristics between these conditions.
Purpose of the Study:
- To prospectively evaluate if middle cerebellar peduncle (MCP) atrophy on MR imaging can differentiate MSA from PD.
- To assess the diagnostic utility of MCP width measurements in distinguishing MSA and PD.
Main Methods:
- Prospective MR imaging study involving 16 patients with MSA, 26 with PD, and 14 healthy controls.
- Independent interpretation of MR images by two blinded neuroradiologists for specific atrophy and hyperintensity patterns.
- Quantitative measurement of MCP width on T1-weighted volumetric spoiled gradient-echo images.
- Statistical analysis using Kruskal-Wallis and Mann-Whitney U tests to compare MCP width across groups.
Main Results:
- Patients with MSA exhibited characteristic MR imaging findings, unlike most PD patients and controls.
- Significantly smaller average MCP width was observed in patients with MSA (6.10 mm) compared to PD patients (9.32 mm) and controls (9.80 mm) (P<.001).
- MCP width measurement demonstrated a clear distinction between MSA and both PD and healthy control groups.
Conclusions:
- Measurement of MCP width using MR imaging is a valuable tool for differentiating MSA from PD.
- Reduced MCP width is a potential imaging biomarker for MSA, aiding in differential diagnosis.
