Table 2

Brain MRI markers of MSA diagnosis6

Changes seenAreas involved for MSA-PAreas involved for MSA-C
Atrophy

  • Putamen

  • Middle cerebellar peduncle

  • Pons

  • Cerebellum

  • Putamen

  • Middle cerebellar peduncle

  • Pons

Increased diffusivity

  • Putamen

  • Middle cerebellar peduncle

  • Putamen

Decreased signal on iron-sensitive sequencesPutaminal rim
T2 hyperintensity‘Hot-cross bun’ sign in pons

  • MSA, multiple system atrophy; MSA-C, MSA-cerebellar; MSA-P, MSA-parkinsonian.