[Clinical and MRI correlation in multiple system atrophy].

By using magnetic resonance imaging (MRI), we studied 11 patients with multiple system atrophy (MSA): 5 olivo-pontocerebellar atrophy (OPCA), 2 Shy-Drager syndrome (SDS), and 4 striatonigral degeneration (SND). The diagnoses of OPCA, SDS and SND were clinically made. The MR images were performed on 1.5 tesla MRI unit (Siemens Asahi Medical, Magnetom H15), using a T2-weighted spin echo (SE) sequence (TR: 2000-3000ms, TE: 80-90ms), a T1-weighted SE sequence (TR: 550, TE: 15), and a proton density-weighted (PD) SE sequence (TR: 2000-3000, TE: 12-22). In the patients with OPCA, MRI revealed cerebellar and brainstem atrophy and degeneration of pontine transverse fibers more marked than in the patients with SDS and SND. T2-weighted images showed low intensity in posterolateral putamina in one OPCA patient and all of SDS and SND patients. PD images demonstrated the abnormal slit-like high signals in posterolateral putamina in three SND. The degree of cerebellar ataxia was not well correlated with cerebellar and brainstem atrophy and degeneration of pontine transverse fibers. There was a positive correlation between the atrophy of cerebellum and brainstem and the duration of cerebellar ataxia. In most of the patients with parkinsonism, MRI demonstrated abnormal low signals in putamina on T2-weighted images. There were positive correlations between the abnormal low signals putamina and the duration and severity of parkinsonism. Though abnormal low signals in lateral putamina may be seen in normal aging and other disorders on T2-weighted images, it is useful to evaluate parkinsonism in MSA.(ABSTRACT TRUNCATED AT 250 WORDS)