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Provost K, La Joie R, Strom A, Iaccarino L, Edwards L, Mellinger TJ, Pham J, Baker SL, Miller BL, Jagust WJ, Rabinovici GD. Crossed cerebellar diaschisis on 18F-FDG PET: Frequency across neurodegenerative syndromes and association with 11C-PIB and 18F-Flortaucipir. J Cereb Blood Flow Metab 2021; 41:2329-2343. [PMID: 33691512 PMCID: PMC8393295 DOI: 10.1177/0271678x211001216] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022]
Abstract
We used 18F-FDG-PET to investigate the frequency of crossed cerebellar diaschisis (CCD) in 197 patients with various syndromes associated with neurodegenerative diseases. In a subset of 117 patients, we studied relationships between CCD and cortical asymmetry of Alzheimer's pathology (β-amyloid (11C-PIB) and tau (18F-Flortaucipir)). PET images were processed using MRIs to derive parametric SUVR images and define regions of interest. Indices of asymmetry were calculated in the cerebral cortex, basal ganglia and cerebellar cortex. Across all patients, cerebellar 18F-FDG asymmetry was associated with reverse asymmetry of 18F-FDG in the cerebral cortex (especially frontal and parietal areas) and basal ganglia. Based on our operational definition (cerebellar asymmetry >3% with contralateral supratentorial hypometabolism), significant CCD was present in 47/197 (24%) patients and was most frequent in corticobasal syndrome and semantic and logopenic variants of primary progressive aphasia. In β-amyloid-positive patients, mediation analyses showed that 18F-Flortaucipir cortical asymmetry was associated with cerebellar 18F-FDG asymmetry, but that cortical 18F-FDG asymmetry mediated this relationship. Analysis of 18F-FDG-SUVR values suggested that CCD might also occur in the absence of frank cerebellar 18F-FDG asymmetry due to symmetrical supratentorial degeneration resulting in a bilateral diaschisis process.
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Affiliation(s)
- Karine Provost
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Taylor J Mellinger
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - William J Jagust
- Lawrence Berkeley National Laboratory, Berkeley, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Lawrence Berkeley National Laboratory, Berkeley, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Naccarato M, Ajčević M, Furlanis G, Lugnan C, Buoite Stella A, Scali I, Caruso P, Stragapede L, Ukmar M, Manganotti P. Novel quantitative approach for crossed cerebellar diaschisis detection in acute ischemic stroke using CT perfusion. J Neurol Sci 2020; 416:117008. [PMID: 32738477 DOI: 10.1016/j.jns.2020.117008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/08/2020] [Accepted: 06/26/2020] [Indexed: 01/31/2023]
Abstract
PURPOSE Crossed cerebellar diaschisis (CCD) is a common finding in hyper-acute ischemic stroke, related to supratentorial dysfunction of the contralateral hemisphere. Several studies investigated a possible relationship between CCD and clinical outcomes but still no evidence emerged. We proposed a novel quantitative whole cerebellum analysis using CT perfusion (CTP) imaging to investigate the relationship between CCD and stroke severity, hypoperfused volume and outcome measures. METHODS 55 patients with supratentorial ischemic stroke who underwent CTP evaluation within 4.5 h since symptom onset were enrolled. CCD was evaluated by CTP image-processing and by calculating the mean transit time (MTT)-map asymmetry index in the whole cerebellum. MTT asymmetry correlation with ischemic volume and clinical outcomes was investigated. RESULTS MTT asymmetry was found in most of the included patients and significantly correlated with NIH Stroke Scale (NIHSS) score at baseline and CTP ischemic volume. MTT asymmetry was significantly correlated with hemorrhagic transformation, NIHSS and modified Rankin Scale (mRS) score on discharge in treated patients. CONCLUSIONS CCD was detectable by CTP in acute supratentorial ischemic stroke by processing the whole cerebellum volume. CCD perfusion asymmetry was significantly correlated with neurological and perfusion deficit on admission as well as with clinical outcomes in treated patients.
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Affiliation(s)
- Marcello Naccarato
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Miloš Ajčević
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy; Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy.
| | - Carlo Lugnan
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Ilario Scali
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Paola Caruso
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Lara Stragapede
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Maja Ukmar
- Radiology Unit, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
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Sharma VK, Sinha AK. Worsening clinical features in a patient with right middle cerebral artery territory stroke – Answer. J Clin Neurosci 2019; 68:350-351. [DOI: 10.1016/j.jocn.2019.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lin T, Lyu Y, Qu J, Cheng X, Fan X, Zhang Y, Hou B, You H, Ma W, Feng F. Crossed cerebellar diaschisis in post-treatment glioma patients: A comparative study of arterial spin labelling and dynamic susceptibility contrast. Eur J Radiol 2018; 107:70-75. [PMID: 30292276 DOI: 10.1016/j.ejrad.2018.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess crossed cerebellar diaschisis (CCD) in post-treatment glioma patients, and to compare the performance of arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) in detecting CCD. METHODS AND MATERIALS This retrospective study included 130 patients who had both DSC and ASL. Among them, 16 had underwent fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). We investigated the relationship between CCD and the location and size of supratentorial lesions, and compared PET diagnostic performance with that of ASL and DSC. We assessed the inter-methods agreement for ASL and DSC, and performed quantitative analysis by calculating the asymmetry index (AI) between bilateral cerebellum and exploring how the AI values for ASL-CBF, DSC-rCBF, and DSC-rCBV maps correlated with each other. RESULT Supratentorial lesions affecting the corona radiata (P < 0.001), basal ganglia (P < 0.001), and insula (P = 0.046) were significantly associated with the occurrence of CCD. Lesion size was significantly larger (P = 0.005) in the CCD positive group. With PET as a reference, ASL-CBF and DSC-rCBF maps exhibited the best diagnostic performance compared with the other DSC-generated maps (diagnostic accuracy = 83.3% for both, area under curve (AUC) of ASL = 0.967, AUC of rCBF = 0.983), although differences were not statistically significant. The κ value for the inter-methods (ASL and DSC) agreement in detecting CCD was 0.893, while the degree of perfusion asymmetry was more significant in ASL- than DSC-generated maps. Bland-Altman plots showed that the AI for ASL-CBF was moderately correlated with those for DSC-rCBF and DSC-rCBV. CONCLUSIONS CCD can present in post-treatment glioma patients and is detectable on MR-perfusion images including ASL-CBF, DSC-rCBF, and DSC-rCBV maps.
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Affiliation(s)
- Tianye Lin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuelei Lyu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Xin Cheng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyuan Fan
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiwei Zhang
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
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Kunz WG, Sommer WH, Höhne C, Fabritius MP, Schuler F, Dorn F, Othman AE, Meinel FG, von Baumgarten L, Reiser MF, Ertl-Wagner B, Thierfelder KM. Crossed cerebellar diaschisis in acute ischemic stroke: Impact on morphologic and functional outcome. J Cereb Blood Flow Metab 2017; 37:3615-3624. [PMID: 28084869 PMCID: PMC5669343 DOI: 10.1177/0271678x16686594] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Crossed cerebellar diaschisis (CCD) is the phenomenon of hypoperfusion and hypometabolism of the contralateral cerebellar hemisphere caused by dysfunction of the related supratentorial region. Our aim was to analyze its influence on morphologic and functional outcome in acute ischemic stroke. Subjects with stroke caused by a large vessel occlusion of the anterior circulation were selected from an initial cohort of 1644 consecutive patients who underwent multiparametric CT including whole-brain CT perfusion. Two experienced readers evaluated the posterior fossa in terms of CCD absence (CCD-) or presence (CCD+). A total of 156 patients formed the study cohort with 102 patients (65.4%) categorized as CCD- and 54 (34.6%) as CCD+. In linear and logistic regression analyses, no significant association between CCD and final infarction volume (β = -0.440, p = 0.972), discharge mRS ≤ 2 (OR = 1.897, p = 0.320), or 90-day mRS ≤ 2 (OR = 0.531, p = 0.492) was detected. CCD+ patients had larger supratentorial cerebral blood flow deficits (median: 164 ml vs. 115 ml; p = 0.001) compared to CCD-patients. Regarding complications, CCD was associated with a higher rate of parenchymal hematomas (OR = 4.793, p = 0.035). In conclusion, CCD is frequently encountered in acute ischemic stroke caused by large vessel occlusion of the anterior circulation. CCD was associated with the occurrence of parenchymal hematoma in the ipsilateral cerebral infarction but did not prove to significantly influence patient outcome.
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Affiliation(s)
- Wolfgang G Kunz
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Wieland H Sommer
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Christopher Höhne
- 2 Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Matthias P Fabritius
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Felix Schuler
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Franziska Dorn
- 3 Department of Neuroradiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Ahmed E Othman
- 4 Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tuebingen, Germany
| | - Felix G Meinel
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Louisa von Baumgarten
- 2 Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Maximilian F Reiser
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Kolja M Thierfelder
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
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Abstract
Crossed cerebellar diaschisis (CCD) describes a depression of oxidative metabolism glucose and blood flow in the cerebellum secondary to a supratentorial lesion in the contralateral cerebral hemisphere. PET/MR has the potential to become a powerful tool for demonstrating and imaging intracranial lesions .We herein report 3 cases of CCD imaging using a tri-modality PET/CT-MR set-up for investigating the value of adding MRI rather than CT to PET in clinical routine.We describe 3 patients with CCD and neurological symptoms in conjunction with abnormal cerebral fluorodeoxyglucose (FDG) positron emission tomography/computed tomography-magnetic resonance imaging (PET/CT-MR) manifestations including arterial spin-labeling (ASL) and T2-weighted images. In all, 18FDG-PET/CT detected positive FDG uptake in supratentorial lesions, and hypometabolism with atrophy in the contralateral cerebellum. More than that, hybrid PET/MRI provided a more accurate anatomic localization and ASL indicated disruption of the cortico-ponto-cerebellar pathway.Using pathology or long-term clinical follow-up to confirm the PET and ASL findings, the supratentorial lesions of the 3 patients were respectively diagnosed with cerebral infarction, recurrent glioma, and metastasis.The reports emphasize the significance of multimodality radiological examinations. Multimodality imaging contributes to proper diagnosis, management, and follow-up of supratentorial lesions with CCD.
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Affiliation(s)
- Shuguang Han
- From the Department of Radiology and the Department of Neurology (SH, KX, CH), Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu Province, PR China (XW)
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Kang KM, Sohn CH, Kim BS, Kim YI, Choi SH, Yun TJ, Kim JH, Park SW, Cheon GJ, Han MH. Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis. AJNR Am J Neuroradiol 2015; 36:1662-8. [PMID: 26228883 DOI: 10.3174/ajnr.a4366] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/20/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Crossed cerebellar diaschisis, not only a secondary result of supratentorial infarction but also an indicator of clinical outcomes, has frequently been reported on PET and SPECT but has been rarely described with arterial spin-labeling MR imaging. The purpose of this study was to determine the ability of arterial spin-labeling MR imaging to evaluate crossed cerebellar diaschisis compared with that of SPECT. To our knowledge, this is the first study to validate arterial spin-labeling in crossed cerebellar diaschisis by using SPECT as a reference standard. MATERIALS AND METHODS This study included 16 patients in whom crossed cerebellar diaschisis was shown on SPECT and 10 control subjects in whom crossed cerebellar diaschisis was not shown on SPECT. During the qualitative analysis, asymmetric cerebellar perfusion on arterial spin-labeling was divided into 1 of the following 3 grades by 2 blinded observers: the affected cerebellum was isointense compared with the unaffected cerebellum (grade I), it was slightly hypointense (grade II), or it was markedly hypointense (grade III). In the quantitative analysis, asymmetry indices were calculated by using SPECT and arterial spin-labeling images. For statistical analysis, κ statistics, the interobserver correlation coefficient, the independent t test, Pearson correlation, and linear regression analysis were used. RESULTS Almost all the diagnoses of crossed cerebellar diaschisis on SPECT were noted on arterial spin-labeling in both qualitative and quantitative analyses with good interobserver agreement (κ = 0.961; interobserver correlation coefficient, 0.806). The mean asymmetry index of arterial spin-labeling (26.06 ± 9.00) was significantly larger than that for SPECT (15.28 ± 5.34; P < .001). There was a significant positive correlation between the asymmetry indices obtained for SPECT and those for arterial spin-labeling (r = 0.77 [95% CI, 0.443-0.916]; P < .001). The relationship of asymmetry indices between SPECT and arterial spin-labeling (x, y) was calculated as y = 6.2131 + 1.2986x (R(2) = 0.592; P < .001). CONCLUSIONS Arterial spin-labeling can be a noninvasive alternative to SPECT for evaluating crossed cerebellar diaschisis.
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Affiliation(s)
- K M Kang
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - C-H Sohn
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine (C.-H.S., S.H.C., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - B S Kim
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y I Kim
- Nuclear Medicine (Y.I.K., G.J.C.), Seoul National University Hospital, Seoul, Republic of Korea
| | - S H Choi
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine (C.-H.S., S.H.C., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - T J Yun
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-h Kim
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S-W Park
- Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Department of Radiology (S.-W.P.), Seoul National University Boramae Hospital, Seoul, Republic of Korea
| | - G J Cheon
- Nuclear Medicine (Y.I.K., G.J.C.), Seoul National University Hospital, Seoul, Republic of Korea
| | - M H Han
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine (C.-H.S., S.H.C., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea
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Fu J, Chen WJ, Wu GY, Cheng JL, Wang MH, Zhuge Q, Li JC, Zhang Q, Zhang Y, Xia NZ, Yang YJ. Whole-brain 320-detector row dynamic volume CT perfusion detected crossed cerebellar diaschisis after spontaneous intracerebral hemorrhage. Neuroradiology 2015; 57:179-87. [PMID: 25381579 DOI: 10.1007/s00234-014-1456-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 10/17/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the value of 320-detector row CT used to detect crossed cerebellar diaschisis (CCD) in patients with unilateral supratentorial spontaneous intracerebral hemorrhage (SICH). METHODS We investigated 62 of 156 patients with unilateral supratentorial SICH using 320-detector row CT scanning. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), and time to peak (rTTP) levels were measured in different regions of interest (ROIs) that were manually outlined on computed tomography perfusion (CTP) for the cerebrum, including normal-appearing brain tissue that surrounded the perilesional low-density area (NA) and the perihematomal low-density area (PA) in all patients and the cerebellum (ipsilateral and contralateral) in CCD-positive patients. RESULTS Of 62 cases, a total of 14 met the criteria for CCD due to cerebellar perfusion asymmetry on CTP maps. In the quantitative analysis, significant differences were found in the perfusion parameters between the contralateral and ipsilateral cerebellum in CCD-positive cases. No significant differences were found between the CCD-positive group and the CCD-negative group according to the hematoma volume, NIHSS scores, and cerebral perfusion abnormality (each P > 0.05). The correlation analysis of the degree of NA, PA perfusion abnormality, and the degree of CCD severity showed negative and significant linear correlations (R, -0.66∼-0.56; P < 0.05). CONCLUSION 320-detector row CT is a robust and practicable method for the comprehensive primary imaging work-up of CCD in unilateral supratentorial SICH patients.
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Ohe Y, Hayashi T, Deguchi I, Fukuoka T, Maruyama H, Kato Y, Tanahashi N. A Case of Nonconvulsive Status Epilepticus with a Reversible Contralateral Cerebellar Lesion: Temporal Changes in Magnetic Resonance Imaging and Single-Photon Emission Computed Tomography Finding. J Stroke Cerebrovasc Dis 2013; 22:e639-42. [DOI: 10.1016/j.jstrokecerebrovasdis.2013.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 03/08/2013] [Accepted: 03/12/2013] [Indexed: 10/26/2022] Open
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O'Gorman RL, Siddiqui A, Alsop DC, Jarosz JM. Perfusion MRI demonstrates crossed-cerebellar diaschisis in sickle cell disease. Pediatr Neurol 2010; 42:437-40. [PMID: 20472198 DOI: 10.1016/j.pediatrneurol.2010.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 12/10/2009] [Accepted: 02/11/2010] [Indexed: 11/29/2022]
Abstract
Arterial spin labeling is a fully noninvasive magnetic resonance perfusion imaging method, ideally suited to pediatric perfusion imaging. We describe an 8-year-old boy with sickle cell disease, extensive right-hemispheric cerebral infarction, and crossed-cerebellar diaschisis apparent on arterial spin labeling perfusion magnetic resonance imaging. To our knowledge, this is the first case of crossed-cerebellar diaschisis demonstrated with arterial spin labeling, highlighting the potential value of perfusion magnetic resonance imaging in the clinical evaluation and follow-up of crossed-cerebellar diaschisis, and the suitability of arterial spin labeling methods for routine perfusion imaging in pediatric patients.
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Affiliation(s)
- Ruth L O'Gorman
- Department of Neuroradiology, King's College Hospital, London, United Kingdom.
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Nguyen D, Delavelle J, Lovblad KO, Vargas MI. Refractory temporal seizures with crossed cerebellar diaschisis assessment with arterial spin-labeling. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.ejrex.2009.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Biaou O, Abderahim R, Soto Ares G, Jissendi Tchofo P. Diaschisis cortico-cérébelleux croisé post-état de mal épileptique. ACTA ACUST UNITED AC 2008; 89:507-9. [DOI: 10.1016/s0221-0363(08)71455-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
We report a girl with refractory partial seizures since 7 years of age, secondary to right frontal cortical dysplasia, who developed MRI and SPECT abnormalities in the contralateral hemicerebellar cortex. These became more marked, leading to left hemicerebellar atrophy. Crossed cerebellar diaschisis has been described mostly in hemispheric stroke and supratentorial tumours, but less often in epilepsy. It is usually a transient phenomenon. This report shows that crossed cerebellar diaschisis can develop within two years of seizure onset and evolve over time.
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Affiliation(s)
- L D Mewasingh
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, 15 Avenue JJ Crocq, Brussels, Belgium
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15
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Ogasawara K, Yasuda S, Yukawa H, Yamagata M, Kin M, Ogawa A. Atypical finding of brain Tc-99m-ECD SPECT imaging in herpes simplex encephalitis. Ann Nucl Med 2002; 16:347-50. [PMID: 12230094 DOI: 10.1007/bf02988619] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Lesions in acute herpes simplex encephalitis (HSE) have been reported to show decreased uptake of Tc-99m ethyl cysteinate dimer (ECD). A patient with acute HSE displaying a lesion in the left temporal lobe was evaluated by means of Tc-99m ECD single-photon emission computed tomography (SPECT). Dynamic SPECT images indicated regionally increased uptake of tracer in the ipsilateral temporal lobe in early phases, followed by slight washout of Tc-99m ECD from the lesion. Static SPECT images revealed increased tracer uptake in the same region. MRI later demonstrated that the HSE lesion involved the whole cortex of the temporal lobe on the affected side. These findings suggest that acute HSE lesions do not always exhibit hypoactivity on static Tc-99m ECD SPECT, and that dynamic Tc-99m ECD SPECT may help physicians diagnose acute HSE.
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Affiliation(s)
- Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
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