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Published online before print March 14, 2002, 10.1148/radiol.2232010722
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(Radiology 2002;223:371-378.)
© RSNA, 2002

Neuroradiology

Proton MR Spectroscopy of the Cerebellum and Pons in Patients with Degenerative Ataxia1

Mario Mascalchi, MD, PhD, Mirco Cosottini, MD, Francesco Lolli, MD, PhD, Fabrizio Salvi, MD, PhD, Carlo Tessa, MD, Marco Macucci, MD, PhD, Michela Tosetti, PhD, Rosaria Plasmati, MD, Alessandra Ferlini, MD, Carlo Alberto Tassinari, MD and Natale Villari, MD

1 From the Section of Diagnostic Radiology, Department of Clinical Physiopathology (M. Mascalchi, C.T., N.V.) and Section of Neurophysiopathology (F.L.), University of Florence, Viale Morgagni 85, 50134 Florence, Italy; Department of Radiology, University of Pisa, Italy (M.C.); Department of Clinical Neurology, Ospedale Bellaria, University of Bologna, Italy (F.S., R.P., C.A.T.); Department of Neurophysiopathology, Ospedale di Empoli, Italy (M. Macucci); IRCSS Stella Maris, Calambrone, Pisa, Italy (M.T.); and Institute of Genetic Medicine, University of Ferrara, Italy (A.F.). Received April 4, 2001; revision requested May 14; revision received July 23; accepted November 20. Supported by grant No. E444 from Telethon-Italy. Address correspondence to M. Mascalchi.

PURPOSE: To investigate whether proton magnetic resonance (MR) spectroscopy is a useful complement to MR imaging in patients with degenerative ataxia.

MATERIALS AND METHODS: Brain MR imaging and single-voxel proton MR spectroscopy of the right cerebellar hemisphere and pons were performed in 30 patients with sporadic (n = 16) or inherited (n = 14) degenerative ataxia and in 20 healthy control subjects. Several indexes of brainstem and cerebellar atrophy were measured on MR images, as well as the N-acetylaspartate/creatine (NAA/Cr), choline/Cr (Cho/Cr), and myo-inositol/Cr (mI/Cr) ratios in the MR spectra. Differences between patients and subjects were evaluated with the Kruskal-Wallis and Mann-Whitney tests, whereas correlation of clinical, MR imaging, and spectroscopic data was assessed with nonparametric Spearman rank correlation.

RESULTS: Measurements of brainstem and cerebellar atrophy obtained from MR images revealed patients had olivopontocerebellar atrophy (OPCA) (n = 11), spinal atrophy (SA) (n = 8), or corticocerebellar atrophy (CCA) (n = 4). Seven patients did not fulfill the criteria for any group and were considered undefined. In patients with OPCA, the pontine and cerebellar NAA/Cr and Cho/Cr ratios were significantly decreased when compared with those of the control subjects. Pontine and cerebellar NAA/Cr ratios were also significantly reduced in patients with SA and CCA. Five patients with undefined ataxia had a substantial decrease of pontine or cerebellar NAA/Cr ratio when compared with that of the control subjects. In patients with OPCA, the pontine NAA/Cr ratio (but not the atrophy measurements) showed a correlation (P = .04) with disability.

CONCLUSION: MR spectroscopy is a useful complement to MR imaging in patients with degenerative ataxia.

© RSNA, 2002

Index terms: Brain, atrophy, 151.1839, 153.1839 • Brainstem, abnormalities, 158.1839 • Brainstem, MR, 158.12145 • Magnetic resonance (MR), spectroscopy, 158.12145 • Spinal cord, diseases, 341.189




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