Abstract
Objectives
To develop a new tract imaging technique for visualising small fibre tracts of the brainstem and for detecting the abnormalities in multiple system atrophy of the cerebellar type (MSA-C) using a phase difference enhanced (PADRE) imaging technique, in which the phase difference between the target and surrounding tissue is selectively enhanced.
Methods
Two neuroradiologists compared the high-spatial-resolution PADRE imaging, which was acquired from six healthy volunteers, three patients with MSA-C, and 7 patients with other types of neurodegenerative diseases involving the brainstem or cerebellum.
Results
Various fine fibre tracts in the brainstem, the superior and inferior cerebellar peduncles, medial lemniscus, spinothalamic tract, medial longitudinal fasciculus, central tegmental tract, corticospinal tract and transverse pontine fibres, were identified on PADRE imaging. PADRE imaging from MSA-C demonstrated the disappearance of transverse pontine fibres and significant atrophy of the inferior cerebellar peduncles, while the superior cerebellar peduncles were intact. PADRE imaging also demonstrated that the transverse pontine fibres and inferior cerebellar peduncle were not involved in the other neurodegenerative diseases.
Conclusion
PADRE imaging can offer a new form of tract imaging of the brainstem and may have the potential to reinforce the clinical utility of MRI in differentiating MSA from other conditions.
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Electronic supplementary material
Supplementary Figures (1–26) shows the sequential PADRE imaging.
The numbers in the PADRE images represent the major anatomical structures analysed in this study. These are 1, inferior cerebellar peduncle; 2, transverse pontine fibre; 3, superior cerebellar peduncle; 4, central tegmental tract; 5, medial longitudinal fasciculus; 6, medial lemniscus; 7, spinothalamic tract; 8, facial nerve; 9, trigeminal nerve; 10, corticospinal tract; 11, inferior olivary nucleus; 12, red nucleus; 13, substantia nigra; and 14, cerebral aqueduct of Sylvius.
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Kakeda, S., Korogi, Y., Yoneda, T. et al. A novel tract imaging technique of the brainstem using phase difference enhanced imaging: normal anatomy and initial experience in multiple system atrophy. Eur Radiol 21, 2202–2210 (2011). https://doi.org/10.1007/s00330-011-2158-7
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DOI: https://doi.org/10.1007/s00330-011-2158-7