“Hot cross bun” sign in multiple system atrophy with predominant cerebellar ataxia: A comparison between proton density-weighted imaging and T2-weighted imaging
Abstract 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 3 T. Methods Sixteen consecutive patients with multiple system atro...
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Published in | European journal of radiology Vol. 81; no. 10; pp. 2848 - 2852 |
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Abstract | Abstract 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 3 T. 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 3 T. 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 3 T. |
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AbstractList | Abstract 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 3 T. 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 3 T. 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 3 T. OBJECTIVETo 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.METHODSSixteen 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.RESULTSIn 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).CONCLUSIONSThe "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. 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. 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. 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). 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. |
Author | Morimoto, Emiko Togashi, Kaori Kondo, Takayuki Takahashi, Ryosuke Kasahara, Seiko Okada, Tomohisa Kanagaki, Mitsunori Yamamoto, Akira Ito, Hidefumi Miki, Yukio |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22209432$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1148/radiology.174.3.2305051 10.3174/ajnr.A1335 10.1034/j.1600-0404.2001.00262.x 10.1016/S0022-510X(00)00339-7 10.1016/S0022-510X(98)00304-9 10.1177/1051228405279988 10.1001/archneur.55.1.33 10.1093/brain/111.1.83 10.1212/WNL.54.3.697 10.1136/jnnp.71.4.565 10.1136/jnnp.65.1.65 10.1007/s00415-002-0734-0 10.1007/BF00588276 10.1148/radiology.194.1.7997565 10.1212/01.wnl.0000324625.00404.15 10.1007/BF00314408 |
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Keywords | Multiple system atrophy MSA-C Olivopontocerebellar atrophy “Hot cross bun” sign Magnetic resonance imaging Proton density-weighted imaging |
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Snippet | Abstract Objective To investigate whether proton density-weighted imaging can detect the “hot cross bun” sign in the pons in multiple system atrophy with... To investigate whether proton density-weighted imaging can detect the “hot cross bun” sign in the pons in multiple system atrophy with predominant cerebellar... To investigate whether proton density-weighted imaging can detect the "hot cross bun" sign in the pons in multiple system atrophy with predominant cerebellar... OBJECTIVETo investigate whether proton density-weighted imaging can detect the "hot cross bun" sign in the pons in multiple system atrophy with predominant... |
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SubjectTerms | Cerebellar Ataxia - pathology Diffusion Magnetic Resonance Imaging - methods Humans Image Enhancement - methods Image Interpretation, Computer-Assisted - methods Magnetic resonance imaging Male Middle Aged MSA-C Multiple system atrophy Multiple System Atrophy - pathology Olivopontocerebellar atrophy Pons - pathology Proton density-weighted imaging Protons Radiology Reproducibility of Results Sensitivity and Specificity “Hot cross bun” sign |
Title | “Hot cross bun” sign in multiple system atrophy with predominant cerebellar ataxia: A comparison between proton density-weighted imaging and T2-weighted imaging |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S0720048X1100859X https://dx.doi.org/10.1016/j.ejrad.2011.12.012 https://www.ncbi.nlm.nih.gov/pubmed/22209432 https://search.proquest.com/docview/1034513023 |
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