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Stroscio G, Cuppari C, Ceravolo MD, Salpietro A, Battaglia F, Sallemi A, Fusco M, Ceravolo A, Iapadre G, Calì E, Impollonia D, Granata F. Radiological Features of Joubert's Syndrome. JOURNAL OF PEDIATRIC NEUROLOGY 2023. [DOI: 10.1055/s-0042-1760241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractJoubert syndrome (JS) is a rare autosomal recessive disorder. All patients affected by this syndrome presented a characteristic picture of cranial fossa malformations, called “molar tooth sign.” This sign is defined by the presence in axial section at the level of a deck/midbrain, of hypo/dysplasia of the cerebellar vermis, abnormally deep interpeduncular fossa and horizontalized thickened and elongated superior cerebellar peduncles. Although “molar tooth sign” is peculiar of JS, other radiological findings have been also reported in these patients. Here, the authors briefly assumed the principal magnetic resonance imaging findings of JS.
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Affiliation(s)
- Giovanni Stroscio
- Unit of Radiology, Department of Human Pathology in Adulthood and Childhood “G. Barresi,” University Hospital of Messina, Messina, Italy
| | - Caterina Cuppari
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | - Maria Domenica Ceravolo
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | | | - Francesco Battaglia
- Orthopaedic and Traumatology Department, “S. Anna” Hospital, University of Ferrara, Ferrara, Italy
| | - Alessia Sallemi
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | - Monica Fusco
- Unit of Pediatric Emergency, Department of Human Pathology of the Adult and Developmental Age “Gaetano Barresi,” University of Messina, Messina, Italy
| | | | - Giulia Iapadre
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
| | - Elisa Calì
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Daniela Impollonia
- Unit of Radiology, Department of Human Pathology in Adulthood and Childhood “G. Barresi,” University Hospital of Messina, Messina, Italy
| | - Francesca Granata
- Unit of Radiology, Department of Human Pathology in Adulthood and Childhood “G. Barresi,” University Hospital of Messina, Messina, Italy
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Machado-Rivas F, Afacan O, Khan S, Marami B, Rollins CK, Ortinau C, Velasco-Annis C, Warfield SK, Gholipour A, Jaimes C. Tractography of the Cerebellar Peduncles in Second- and Third-Trimester Fetuses. AJNR Am J Neuroradiol 2021; 42:194-200. [PMID: 33431505 PMCID: PMC7814802 DOI: 10.3174/ajnr.a6869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/24/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Little is known about microstructural development of cerebellar white matter in vivo. This study aimed to investigate developmental changes of the cerebellar peduncles in second- and third-trimester healthy fetuses using motion-corrected DTI and tractography. MATERIALS AND METHODS 3T data of 81 healthy fetuses were reviewed. Structural imaging consisted of multiplanar T2-single-shot sequences; DTI consisted of a series of 12-direction diffusion. A robust motion-tracked section-to-volume registration algorithm reconstructed images. ROI-based deterministic tractography was performed using anatomic landmarks described in postnatal tractography. Asymmetry was evaluated qualitatively with a perceived difference of >25% between sides. Linear regression evaluated gestational age as a predictor of tract volume, ADC, and fractional anisotropy. RESULTS Twenty-four cases were excluded due to low-quality reconstructions. Fifty-eight fetuses with a median gestational age of 30.6 weeks (interquartile range, 7 weeks) were analyzed. The superior cerebellar peduncle was identified in 39 subjects (69%), and it was symmetric in 15 (38%). The middle cerebellar peduncle was identified in all subjects and appeared symmetric; in 13 subjects (22%), two distinct subcomponents were identified. The inferior cerebellar peduncle was not found in any subject. There was a significant increase in volume for the superior cerebellar peduncle and middle cerebellar peduncle (both, P < .05), an increase in fractional anisotropy (both, P < .001), and a decrease in ADC (both, P < .001) with gestational age. The middle cerebellar peduncle had higher volume (P < .001) and fractional anisotropy (P = .002) and lower ADC (P < .001) than the superior cerebellar peduncle after controlling for gestational age. CONCLUSIONS A robust motion-tracked section-to-volume registration algorithm enabled deterministic tractography of the superior cerebellar peduncle and middle cerebellar peduncle in vivo and allowed characterization of developmental changes.
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Affiliation(s)
- F Machado-Rivas
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - O Afacan
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - S Khan
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - B Marami
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - C K Rollins
- Department of Radiology, Department of Neurology (C.K.R.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - C Ortinau
- Department of Pediatrics (C.O.), Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - C Velasco-Annis
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
| | - S K Warfield
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - A Gholipour
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
| | - C Jaimes
- Computational Radiology Laboratory (F.M.-R., O.A., S.K., B.M., C.V.-A., S.K.W., A.G., C.J.)
- Fetal-Neonatal Neuroimaging and Developmental Science Center (C.J.), Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School (F.M.-R., O.A., S.K., B.M., C.K.R., S.K.W., A.G., C.J.), Boston, Massachusetts
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Meoded A, Huisman TAGM. Diffusion Tensor Imaging of Brain Malformations: Exploring the Internal Architecture. Neuroimaging Clin N Am 2019; 29:423-434. [PMID: 31256863 DOI: 10.1016/j.nic.2019.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diffusion tensor imaging (DTI) is an advanced MR imaging technique that provides noninvasive qualitative and quantitative information about the white matter microarchitecture. By measuring the three-dimensional directional characteristics of water molecule diffusion/mobility, DTI generates unique tissue contrasts that are used to study the axonal organization of the central nervous system. Its applications include quantitative evaluation of the brain connectivity, development, and white matter diseases. This article reviews DTI and fiber tractography findings in several brain malformations and highlights the added value of DTI and fiber tractography compared with conventional MR imaging.
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Affiliation(s)
- Avner Meoded
- Johns Hopkins All Children's Hospital, 501 6th Avenue South, St Petersburg, FL 33701, USA.
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin Street, Suite 470, Houston, TX 77030, USA
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Review of Ocular Manifestations of Joubert Syndrome. Genes (Basel) 2018; 9:genes9120605. [PMID: 30518138 PMCID: PMC6315342 DOI: 10.3390/genes9120605] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/13/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
Joubert syndrome is a group of rare disorders that stem from defects in a sensory organelle, the primary cilia. Affected patients often present with disorders involving multiple organ systems, including the brain, eyes, and kidneys. Common symptoms include breathing abnormalities, mental developmental delays, loss of voluntary muscle coordination, and abnormal eye movements, with a diagnostic “molar tooth” sign observed by magnetic resonance imaging (MRI) of the midbrain. We reviewed the ocular phenotypes that can be found in patients with Joubert syndrome. Ocular motor apraxia is the most frequent (80% of patients), followed by strabismus (74%) and nystagmus (72%). A minority of patients also present with ptosis (43%), chorioretinal coloboma (30%), and optic nerve atrophy (22%). Although mutations in 34 genes have been found to be associated with Joubert syndrome, retinal degeneration has been reported in only 38% of patients. Mutations in AHI1 and CEP290, genes critical to primary cilia function, have been linked to retinal degeneration. In conclusion, Joubert syndrome is a rare pleiotropic group of disorders with variable ocular presentations.
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