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[MR evaluation of wallerian degeneration of the pyramidal tract]
Abstract:
This study is based on 135 magnetic resonance (MR) exams of 110 patients with wallerian degeneration of the pyramidal tract shown on MR images acquired on a mid field imaging scanner. The MR findings of wallerian degeneration were abnormal signal band along the course of the pyramidal tract and ipsilateral brain stem shrinkage. In all 110 cases an abnormal signal band was seen on T2-weighted spin-echo images, that is, a hypointense band in four exams between 30 days and 116 days after onset of symptoms, and hyperintense bands in 122 exams. The hyperintense signal on T2-weighted images was shown in most cases after 200 days from the onset. In one case a signal of the pyramidal tract showed a hyperintense band at 7 days, hypointense at 30 days, and hyperintense again at 123 days after onset. Sequential MR exams of another case showed gradual narrowing of the hyperintense signal band and progression of the ipsilateral brainstem shrinkage. The narrowing of the pyramidal tract and the ipsilateral brain stem shrinkage tended to be shown after 6 months from onset.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Magnetic resonance (MR) imaging reveals abnormal signal bands and brainstem shrinkage in wallerian degeneration of the pyramidal tract. These findings, particularly hyperintense signals on T2-weighted images, appear after symptom onset and progress over time.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Context:
- Wallerian degeneration affects the pyramidal tract, a crucial pathway for motor control.
- Magnetic resonance (MR) imaging is a key modality for visualizing neurological changes.
- Understanding the temporal evolution of MR findings in wallerian degeneration is essential for diagnosis and prognosis.
Purpose:
- To characterize the magnetic resonance (MR) imaging findings associated with wallerian degeneration of the pyramidal tract.
- To investigate the temporal appearance and evolution of MR signal abnormalities and structural changes.
- To correlate MR findings with the clinical timeline of symptom onset.
Summary:
- 135 MR exams from 110 patients with wallerian degeneration of the pyramidal tract were analyzed.
- Abnormal signal bands along the pyramidal tract and ipsilateral brainstem shrinkage were consistently observed.
- Hyperintense signals on T2-weighted spin-echo images were common, typically appearing after 200 days, while hypointense signals were seen earlier. Progressive narrowing of the tract and brainstem shrinkage were noted after 6 months.
Impact:
- Provides a detailed description of MR imaging characteristics of wallerian degeneration.
- Establishes a timeline for the appearance and progression of key imaging biomarkers.
- Aids in the early and accurate diagnosis of pyramidal tract degeneration using MR imaging.