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Focal signal abnormalities at the depth of the cerebellar fissures in children have been reported and hypothesized to represent a novel pattern of bottom-of-fissure dysplasia. The authors report a series of 23 patients with a similar distribution and appearance of cerebellar signal abnormality attributable to watershed injury. T2 prolongation was observed at the depths of the cerebellar fissures bilaterally in all 23 patients, centered at the expected location of the deep cerebellar vascular borderzone. Diffusion restriction was associated with MR imaging performed during acute injury in 13/16 patients. Five of 23 patients had prior imaging, all demonstrating a normal cerebellum. The etiology of injury was hypoxic-ischemic injury in 17/23 patients, posterior reversible encephalopathy syndrome in 3/23 patients, and indeterminate in 3/23 patients.

Anatomic images covering the cervical spinal cord from the C1 to C6 levels and DTI, magnetization transfer/inhomogeneous magnetization transfer images at the C2/C5 levels were acquired in 19 patients with MS and 19 paired healthy controls. Anatomic images were segmented in spinal cord GM and WM, both manually and using the AMU40 atlases. MS lesions were manually delineated. MR imaging metrics were analyzed within normal-appearing and lesion regions in anterolateral and posterolateral WM and compared using Wilcoxon rank tests and z scores. The use of a multiparametric MR imaging protocol combined with an automatic template-based GM/WM segmentation approach in the current study outlined a higher sensitivity of the ihMT technique toward spinal cord pathophysiologic changes in MS compared with atrophy measurements, DTI, and conventional MT. The authors also conclude that the clinical correlations between ihMTR and functional impairment observed in patients with MS also argue for its potential clinical relevance, paving the way for future longitudinal multicentric clinical trials in MS.