Spinocerebellar degeneration: qualitative and quantitative MR analysis of atrophy

Magnetic resonance imaging at 1.5 T was performed in 27 patients with either the cerebellar or spinocerebellar form of spinocerebellar degeneration and in 10 control subjects. Neither T1- nor T2-weighted images (T1WIs and T2WIs) of the patients showed any abnormal intensity areas within the cerebellum or in any other structures of the brain. The T2WIs delineated normal configurations of symmetrical dentate and red nuclei. On T1WIs two patterns of atrophy were detected: (a) moderate to severe shrinkage of the basis pontis and the middle cerebellar peduncles associated with atrophy of the cerebellum, and (b) moderate atrophy of the cerebellum with a preserved basis pontis. The former morphological changes are consistent with the pathology of pontocerebellar atrophy (PCA) and the latter with those of cerebellar cortical degeneration (CCD). In 11 patients, only after a quantitative analysis of the images were we able to classify them in one of the two morphological categories (PCA or CCD). There was a significant correlation between atrophy of the cerebellum and atrophy of the basis pontis. Furthermore, in the PCA group the anterior portion of the body of the corpus callosum was significantly smaller in comparison with the control subjects.