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Eur J Radiol. 2012 Oct;81(10):2848-52. doi: 10.1016/j.ejrad.2011.12.012. Epub 2011 Dec 29.

"Hot cross bun" sign in multiple system atrophy with predominant cerebellar ataxia: a comparison between proton density-weighted imaging and T2-weighted imaging.

Author information

1
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan. nuun077@kuhp.kyoto-u.ac.jp

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 3T.

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 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.

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 3T.

PMID:
22209432
DOI:
10.1016/j.ejrad.2011.12.012
[Indexed for MEDLINE]
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