'Hot-cross bun sign' of multiple system atrophy.
نویسندگان
چکیده
OBJECTIVE To investigate whether proton density-weighted imaging can detect the "hot cross bun" sign in the pons in multiple system atrophy with predominant cerebellar ataxia significantly better than T2-weighted imaging at 3T. METHODS Sixteen consecutive patients with multiple system atrophy with predominant cerebellar ataxia according to the Consensus Criteria were reviewed. Axial unenhanced proton density-weighted imaging and T2-weighted imaging were obtained using a dual-echo fast spin-echo sequence at 3T. Two neuroradiologists independently evaluated visualisation of the abnormal pontine signal using a 4-point visual grade from Grade 0 (no "hot cross bun" sign) to Grade 3 (prominent "hot cross bun" sign on two or more sequential slices). Differences in grade between proton density-weighted imaging and T2-weighted imaging were statistically analysed using the Wilcoxon signed-rank test. RESULTS In 11 patients (69%), a higher grade was given for proton density-weighted imaging than T2-weighted imaging. In 1 patient (6%), grades were the same (Grade 3) on both images. In the remaining 4 patients (25%), signal abnormalities were not detected on either image (Grade 0). The "hot cross bun" sign was thus observed significantly better on proton density-weighted imaging than on T2-weighted imaging (P=0.001). CONCLUSIONS The "hot cross bun" sign considered diagnostic for multiple system atrophy with predominant cerebellar ataxia is significantly better visualised on proton density-weighted imaging than on T2-weighted imaging at 3T.
منابع مشابه
[Optical neuropathy in Lewis-Summer syndrome: a casual relationship?].
1. Wenning GK, Colosimo G, Geser F, Poewe W. Multiple system atrophy [review]. Lancet Neurol. 2004;3:93—103. 2. Sitburana O, Ondo WG. Brain magnetic resonance imaging (MRI) in parkinsonian disorders. Parkinsonism Relat Disord. 2009;15:165—74. 3. Pereiro I, Arias M, Requena I. Signo de santiaguiño en la atrofia multisistémica. Neurologia. 2010;25:336—7. 4. Shrivastava A. The hot cross bun sign. ...
متن کاملHot cross bun sign in a case with multisystem atrophy
A 65-year-old man came to our clinic with progressive disequilibrium and gait problem since 6 years. During this period, he had also urinary incontinency. On neurologic examination, he had scanning speech and bidirectional nystagmus. There was hypokinesia in upper and lower limbs and on cerebellar tests finger to nose and heel to shin were impaired (severe dysmetria); he was unable to walk with...
متن کاملHot Cross Bun Sign Following Bilateral Pontine Infarction: A Case Report
The hot cross bun sign is characterized by cruciform T2 signal hyperintensity in the pons and has been reported to be a specific but not pathognomic for multiple system atrophy. It reflects degeneration of pontine neurons and transverse pontocerebellar fibers, regardless of the underlying pathogenic process. Here, we report a case of hot cross bun sign following bilateral pontine infarction due...
متن کامل"Hot cross bun" sign in variant Creutzfeldt-Jakob disease.
Disease The “hot cross bun” sign refers to pontine cruciform hyperintensity on long TR sequences, which can be observed in multiple-system atrophy, spinocerebellar atrophy types 2 and 3, and in parkinsonism secondary to vasculitis. It has not been previously demonstrated in variant Creutzfeldt-Jakob disease (vCJD), to our knowledge. A 16-year-old girl, diagnosed with vCJD at age 14 years and de...
متن کاملPontine calcification in late stage cerebellar multiple system atrophy: a marker of synucleinopathy neurodegeneration?
A 78-year-old woman presented with progressive ataxia, dysautonomia (hypotension and urinary incontinence), and pyramidal signs that started 17 years ago. Brain MRI performed 15 years ago showed pontocerebellar atrophy and the “hot cross bun” sign (Figure 1). Multiple system atrophy, cerebellar form (MSA-C) was diagnosed. A routine brain CT scan performed two years ago disclosed pontine calcifi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Internal medicine
دوره 46 22 شماره
صفحات -
تاریخ انتشار 2007