MRI在鉴别多系统萎缩与帕金森病中的价值

目的 探讨常规MR在鉴别多系统萎缩(MSA)与帕金森病(PD)中的价值. 资料与方法 回顾性分析经临床诊断为MSA的26例患者常规MR资料,另外搜集经临床诊断为PD的27例患者常规MR资料为对照组. 结果 12项MR表现中,幕下的MR表现有十字征、小脑中脚高信号、桥脑高信号、小脑萎缩、小脑中脚萎缩、延髓萎缩、桥脑萎缩、第四脑室扩大、桥前池扩大.幕上的MR表现有壳核边缘高信号、壳核高信号、壳核萎缩.幕下的MR表现鉴别MSA和PD均有统计学意义(P＜0.05).而幕上的MR表现鉴别MSA和PD均无统计学意义(P＞0.05).敏感性较高的是小脑中脚萎缩和小脑萎缩,特异性和阳性预测值较高的是十字征、小脑中脚高信号. 结论 常规MR有助于MSA与PD鉴别诊断.

The Value of MRI in Differential Diagnosis between MSA and Parkinson's Disease

Objective To explore the value of routine MRI in differential diagnosis between MSA and PD. Materials and Methods MRI features of 26 patients with MSA were retrospectively analyzed. 27 patients with PD were regarded as control. Results Among 12 MRI findings, infratentorial MRI findings included hot-cross bun' sigh, hyperintensity of the middle cerebellar peduncles, hyperintensity of the pons, cerebellar atrophy, atrophy of the middle cerebellar peduncles, medulla oblongata atrophy, pontine atrophy, fourth ventricle dilatation and pc dilatation. Supratentorital MRI findings included hyperintense rim of the putamen, putaminal hyperintensity and putaminal atrophy. All the infratentorial MRI findings had statistically significant (P<0.05) to identify the MSA and PD, while supratentorital MRI findings were not valid to differentiate MSA from PD (P>0.05). Among all MRI findings, the high sensitive features were cerebellar atrophy and atrophy of the middle cerebellar peduncles, The high specific feature and positive predictive value were hot-cross bun' sigh and hyperintensity of the middle cerebellar peduncles. Conclusion The routine MRI is helpful in differential diagnosis between MSA and PD.