Value of quantitative midbrain measurement in differentiating progressive supranuclear palsy from Parkinson's disease and multiple system atrophy
10.3760/cma.j.issn.1006-7876.2018.08.006
- VernacularTitle:中脑磁共振定量测量对进行性核上性麻痹、多系统萎缩和帕金森病的鉴别诊断价值
- Author:
Han WANG
1
;
Yiwei ZHANG
;
Jing YUAN
;
Dan XU
;
Hui YOU
;
Mingli LI
;
Feng FENG
Author Information
1. 100730中国医学科学院北京协和医院神经科
- Keywords:
Supranuclear palsy,progressive;
Magnetic resonance imaging;
Mesencephalon;
Diagnosis,differential
- From:
Chinese Journal of Neurology
2018;51(8):586-591
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness of quantitative midbrain measurements in differentiating progressive supranuclear palsy (PSP) from multiple system atrophy (MSA) and Parkinson's disease (PD).Methods Quantitative midbrain measurements,including midbrain width (MW),midbrain to pons ratio (M/P) and magnetic resonance parkinsonism index (MRPI),were performed in patients with parkinsonism who were diagnosed in the Movement Disorder Clinic of Peking Union Medical College Hospital during the period of January to September 2017.A cross-sectional study was conducted in the series to evaluate the effectiveness of these quantitative measurements.Results Ten PSP-RS,15 MSA-P and 49 PD patients were included in this study.The values of MW,M/P and MRPI in PSP-RS patients were (8.21 ± 1.30) mm,0.49 ±0.06 and 15.26 ±4.53,respectively,with statistically significant difference compared toMSA-P ((10.24±0.77) mm,0.65 ±0.09,7.75 ±2.71) and PD patients ((10.53 ±0.93) mm,0.62±0.06,9.86 ±2.46;F=24.27,18.37,21.47,all P＜0.01).After adjusting for age,disease course and gender,analysis of covariance suggested significant correlation between the quantitative midbrain measurements and diagnosis of these diseases.Receiver operating characteristic curve indicated that MW ≤9.4 mm,M/P≤0.57 and MRPI ＞ 10.77 showed ideal sensitivity and specificity (90.0％ and 92.1％,80.0％ and 93.7％,100.0％ and 82.5％) in differentiating PSP-RS from MSA-P and PD.Conclusion Quantitative measurement of midbrain atrophy is useful in differentiating PSP-RS from MSA-P and PD.
