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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

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Cerebellar lesions in multiple system atrophy: postmortem MR imaging-pathologic correlations.

E Matsusue¹, S Fujii, Y Kanasaki

¹Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan. matsusue@grape.med.tottori-u.ac.jp

AJNR. American Journal of Neuroradiology

|June 23, 2009

Summary

This summary is machine-generated.

Multiple system atrophy (MSA) involves cerebellar atrophy and white matter lesions. Postmortem MRI revealed that white matter hyperintensities correlate with myelin loss and gliosis, while dentate nucleus hypointensities indicate ferritin deposition.

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Area of Science:

Neuropathology
Neuroimaging
Multiple System Atrophy Research

Background:

Cerebellar lesions, including atrophy and white matter T2-hyperintensities, are hallmarks of multiple system atrophy (MSA).
Understanding the correlation between imaging findings and histological changes is crucial for diagnosing and characterizing MSA pathology.

Purpose of the Study:

To correlate magnetic resonance imaging (MRI) findings with histological evidence in the cerebellar lesions of multiple system atrophy (MSA).
To elucidate the pathological basis of T2-hyperintensities and hypointensities observed in the cerebellum of MSA patients.

Main Methods:

Postmortem T2-weighted MRI at 1.5T was performed on 7 cases with pathologically confirmed MSA.
MR imaging findings of cerebellar cortices and deep white matter dentate nucleus regions were systematically compared with corresponding histological findings.

Main Results:

Three types of cerebellar changes were identified: no atrophy/signal changes, atrophy with patchy/confluent white matter hyperintensities, and atrophy with diffuse white matter hyperintensities.
Cerebellar white matter atrophy was more pronounced than cortical atrophy. White matter hyperintensities corresponded histologically to loss of myelinated fibers and gliosis.
Hypointensities in the dentate nucleus regions were associated with diffuse ferritin deposition within preserved nuclei and surrounding white matter.

Conclusions:

Cerebellar white matter hyperintensities on MRI reflect degenerated white matter characterized by myelin loss and gliosis in MSA.
Hypointensities in the dentate nucleus region are indicative of ferritin deposition in preserved neural structures.
The pathological changes, particularly degeneration, are more severe in the cerebellar white matter compared to the cerebellar cortices in MSA.