18 F-FDG PET/MRI in Multiple System Atrophy-Parkinsonian Type (MSA-P).

Area of Science:

• Neuroscience
• Radiology
• Neurology

Background:

• Multiple system atrophy (MSA) is a rare, sporadic neurodegenerative disorder.
• It is characterized by autonomic dysfunction, parkinsonism, and cerebellar ataxia.
• Parkinsonian type (MSA-P) predominantly presents with parkinsonian features.

Purpose of the Study:

• To present a clinical case of multiple system atrophy, parkinsonian type (MSA-P).
• To correlate clinical presentation with advanced neuroimaging findings.
• To emphasize the diagnostic utility of 18F-FDG PET/MRI in MSA-P.

Main Methods:

• Clinical case presentation of a 64-year-old woman with a 4-year history of progressive movement disorder.
• DaTScan imaging to evaluate for Parkinsonian syndrome.
• 18F-FDG PET/MRI to assess brain metabolism and structure.

Main Results:

• Patient exhibited freezing of gait, discoordination, orthostatic symptoms, and urinary incontinence.
• DaTScan was abnormal, consistent with Parkinsonian syndrome.
• 18F-FDG PET/MRI revealed decreased uptake in bilateral putamina, putaminal atrophy, the putaminal rim sign, and central T2* hypointensity.

Conclusions:

• The combined clinical and imaging findings strongly support a diagnosis of MSA-P.
• 18F-FDG PET/MRI is valuable for diagnosing MSA-P, showing characteristic patterns of putaminal degeneration.
• Early and accurate diagnosis is crucial for managing MSA-P and its associated symptoms.