title: MR imaging of middle cerebellar peduncle width: differentiation of multiple system atrophy from Parkinson disease.
abstract: OBJECTIVE
  To prospectively assess if middle cerebellar peduncle (MCP) atrophy, evaluated at magnetic resonance (MR) imaging, can help differentiate multiple system atrophy (MSA) from Parkinson disease (PD).
  
  
  METHODS
  All participants provided informed consent for participation in the study, which was approved by the institutional review board. Sixteen consecutive patients with MSA, 26 consecutive patients with PD, and 14 healthy control subjects were examined with MR imaging. Images were interpreted independently by two experienced neuroradiologists blinded to clinical information, who visually inspected the images for the presence or absence of putaminal atrophy, putaminal hypointensity, slitlike hyperintensity in the posterolateral margin of the putamen, brainstem atrophy, hyperintensity of the MCP, and cruciform hyperintensity of the pons. Measurements of MCP width on T1-weighted volumetric spoiled gradient-echo images were performed in all subjects. Differences in MCP width among the groups were evaluated by using the Kruskall-Wallis test, followed by the Mann-Whitney U test for multiple comparisons and Bonferroni correction.
  
  
  RESULTS
  All patients (mean age, 63.88 years; range, 55-72 years) with MSA had at least one of the features commonly observed in this disease on MR images, whereas control subjects (mean age, 66.93 years; range, 61-77 years) and all but one patient with PD (mean age, 65.31 years; range, 51-79 years) had normal MR images. The average MCP width was significantly smaller in patients with MSA (6.10 mm+/-1.18 [standard deviation]) than in those with PD (9.32 mm+/-0.77, P<.001) or control subjects (9.80 mm+/-0.66, P<.001).
  
  
  CONCLUSIONS
  Measurement of MCP width on MR images may be useful for distinguishing patients with MSA from those with PD.
authors.affiliation: Institute of Neurological Sciences, National Research Council, Mangone, Cosenza, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nicoletti
authors.forename: Francesco
authors.initials: F
authors.lastname: Fera
authors.forename: Francesca
authors.initials: F
authors.lastname: Condino
authors.forename: William
authors.initials: W
authors.lastname: Auteri
authors.forename: Olivier
authors.initials: O
authors.lastname: Gallo
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Pugliese
authors.forename: Gennarina
authors.initials: G
authors.lastname: Arabia
authors.forename: Letterio
authors.initials: L
authors.lastname: Morgante
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
authors.forename: Mario
authors.initials: M
authors.lastname: Zappia
authors.forename: Aldo
authors.initials: A
authors.lastname: Quattrone
mesh_terms: D000368:Aged; D001284:Atrophy; D001933:Brain Stem / Q000473:pathology; D002531:Cerebellum / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis*; D011149:Pons / Q000473:pathology; D011446:Prospective Studies; D011699:Putamen / Q000473:pathology; D016037:Single-Blind Method