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Congress: ECR25
Poster Number: C-22823
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-22823
Authorblock: A. Ben Khalifa, I. Dkhil, M. Ben Hafsa, M. Inoubli, S. Jelassi, I. Bouzaouache, A. Jelassi, D. Nouri, S. Nagi; TUNIS/TN
Disclosures:
Asma Ben Khalifa: Nothing to disclose
Insaf Dkhil: Nothing to disclose
Meriem Ben Hafsa: Nothing to disclose
Marwa Inoubli: Nothing to disclose
Soumaya Jelassi: Nothing to disclose
Ines Bouzaouache: Nothing to disclose
Achref Jelassi: Nothing to disclose
Dorsaf Nouri: Nothing to disclose
Sonia Nagi: Nothing to disclose
Keywords: Neuroradiology brain, MR, Education, Cerebral palsy
Learning objectives This poster explores the differential diagnosis of bilateral middle cerebellar peduncle (MCP) lesions, focusing on neuroimaging findings and underlying pathologies.
Read more Background Middle cerebellar peduncle (MCP) lesions, though rare, present as abnormal T2-weighted hyperintensities on MRI, sometimes with variable enhancement and diffusivity changes. Bilateral MCP signal anomalies may occur in a range of neurological conditions, including: Cerebrovascular events Demyelinating disorders Metabolic diseases Neurodegenerative conditions These anomalies are typically related to myelin abnormalities, edema, or neurodegeneration, making accurate identification essential for diagnosis (1).
Read more Findings and procedure details Etiologies Bilateral MCP signal anomalies are associated with diverse conditions, including: Cerebrovascular events: Acute and chronic pontine infarcts, hematoma (Figure 1), Wallerian degeneration (2). Demyelinating disorders: Behçet’s disease (Figure 2), multiple sclerosis (MS) (Figure 3), Neuromyelitis optica spectrum disorders (NMOSD)  (Figure 4) (3). Metabolic conditions: Wilson’s disease (Figure 5), mitochondrial disorders (Figure 6) (4,5). Neurodegenerative diseases: Multiple system atrophy (MSA), spinocerebellar ataxias (SCA) (6,7). Genetic origins: Fragile X syndrome, LBSL (leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation), duplication lamin B1 (8). Enzymatic deficiencies:...
Read more Conclusion : Though uncommon, bilateral MCP signal anomalies are significant radiological findings requiring careful evaluation to determine the underlying cause. MRI remains the gold standard for detecting and characterizing these lesions, providing critical insights for differentiating between: Cerebrovascular disorders Demyelinating diseases Metabolic conditions Neurodegenerative processes Correlating imaging findings with clinical and laboratory data is essential for precise diagnosis and effective treatment planning.
Read more References Okamoto K, Tokiguchi S, Furusawa T, Ishikawa K, Quardery AF, Shinbo S, et al. MR Features of Diseases Involving Bilateral Middle Cerebellar Peduncles. 2003; Yin S, Jin CX, Zhang DP, Peng YF. Magnetic resonance imaging evaluation of Wallerian degeneration of bilateral middle cerebellar peduncles after pontine infarction. SMJ. déc 2019;40(12):1278‑84. Filippi M, Preziosa P, Banwell BL, Barkhof F, Ciccarelli O, De Stefano N, et al. Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines. Brain. 1 juill 2019;142(7):1858‑75. Litwin T,...
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