Clinical and Radiological Features of Wallerian Degeneration of the Middle Cerebellar Peduncles Secondary to Pontine Infarction

作     者：Zhi-Yong Zhang Zhi-Qin Liu Wei Qin Ya-Wen Chen Zun-Jing Liu Zhang Zhi-Yong;Liu Zhi-Qin;Qin Wei;Chen Ya-Wen;Liu Zun-Jing

作者机构：Department of Neurology China-Japan Friendship Hospital Beijing 100029 China Department of Neurology Xi'an Central Hospital Xi'an Jiaotong University School of Medicine Xi'an Shaanxi 710003 China Department of Neurology Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2018年第131卷第6期

页      面：665-671页

核心收录：

学科分类：0711[理学-系统科学] 082704[工学-辐射防护及环境保护] 1002[医学-临床医学] 07[理学] 08[工学] 0827[工学-核科学与技术] 

基　　金：This work was supported by grants from the National Natural Science Foundation of China （No. 81173595）  the China-Japan Friendship Hospital Youth Science and Technology Excellence Project （No. 2014-QNYC-A-04）  and the Research Fund of the China-Japan Friendship Hospital （No. 2015-2-QN-39）. 

主　　题：Magnetic Resonance Imaging Middle Cerebellar Peduncles Neurological Prognosis Pontine Infarction WallerianDegeneration 

摘      要：Background： Wallerian degeneration （WD） of bilateral middle cerebellar its characteristics have not yet been clarified because of the low incidence peduncles （MCPs） can occur following pontine infarction, but Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease. Methods： Clinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group （patients with pontine infarction had no secondary WD）. Results： This study involved 30 patients with WD of MCPs, with a detection rate of only 4.9%. The primary infarctions （χ2 -24.791, P = 0.001, vs. control group） were located in the paramedian pons in 21 cases （70.0%）, and ventrolateral pons in nine cases （30.0%）. WD of the MCPs was detected 8-24 weeks after pons infarction using conventional magnetic resonance imaging （M RI）; all secondary WDs were asymptomatic and detected incidentally. All WD lesions exhibited bilateral, symmetrical, and boundary blurring on MRI. The signal features were hypointense on Tl-weighted imaging, hyperintense on T2-weighted imaging and fluid-attenuated inversion recovery, and slightly hyperintense or isointense on diffusion-weighted imaging and apparent diffusion coefficient maps. Secondary brainstem atrophy was found in six （20.0%） cases. A Modified Rankin Scale score 0-2 was found in 10 （33.3%） cases and score 〉2 in 20 （66.7%） cases at 90 days after discharge, and the short-term prognosis was worse than that in control group （χ2 =12.814, P - 0.001 ）. Conclusions： Despite the rarity of bilateral and symmetrical lesions of MCPs, secondary WD should be highly suspected if these lesions occur within 6 months after pontine infarction, particularly parainedian ports. Conventional MRI appears to be a relatively sensitive method for detecting WD of MCPs, which might affect the short-term prognosis.