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Differentiation of SCA2 from MSA‐C using proton magnetic resonance spectroscopic imaging
Author(s) -
Boesch Sylvia M.,
Wolf Christian,
Seppi Klaus,
Felber Stephan,
Wenning Gregor K.,
Schocke Michael
Publication year - 2007
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20846
Subject(s) - nuclear magnetic resonance , magnetic resonance imaging , spinocerebellar ataxia , creatine , nuclear medicine , medicine , sagittal plane , cerebellum , echo time , white matter , atrophy , pathology , chemistry , radiology , physics , disease
Purpose To assess and compare biochemical and volumetric features of the cerebellum in patients with spinocerebellar ataxia type 2 (SCA2) and patients with the cerebellar variant of multiple system atrophy (MSA‐C). Materials and Methods Nine genetically assigned SCA2 patients and six MSA‐C patients who met the clinical criteria of MSA‐C underwent a clinical and neuroradiological workup with respect to cerebellar features. The MR protocol consisted of a sagittal T1‐weighted three‐dimensional fast low‐angle shot (3D FLASH) sequence and a transversal T2‐ and spin‐density‐weighted turbo spin‐echo sequence. The proton magnetic resonance spectroscopic imaging ( 1 H‐MRSI) protocol consisted of two chemical shift imaging (CSI) sequences (echo time (TE) = 20 and 135 msec). Results Both short‐ and long‐TE MR spectroscopy (MRS) images showed significant decreases in values for N ‐acetylaspartate to creatine (NAA/Cr), and choline to creatine (Cho/Cr) ratios in MSA‐C and SCA2 compared to normal controls, though there was no difference between the two patient groups. In contrast, distinct cerebellar lactate (Lac) peaks were detected in seven SCA2 patients, and small peaks were detected in two. However, we did not detect any definite Lac peak in MSA‐C or control subjects. Conclusion MRSI revealed Lac pathology in SCA2 but not in MSA‐C. Whether this indicates distinct pathogenetic mechanisms of cerebellar degeneration remains to be established. J. Magn. Reson. Imaging 2007;25:564–569. © 2007 Wiley‐Liss, Inc.