磁共振形态学测量帕金森叠加综合征  

Morphologic MRI in measure of Parkinsonism-plus syndrome

作　　者：傅方望[1] 贺丹[2] 郝烘玉[2] 王婷婷[2] 刘辉[2] 

机构地区：[1]温州医科大学附属第二医院神经内科,浙江温州325000 [2]河北医科大学第二医院神经内科,河北石家庄050000

出　　处：《中国医学影像技术》2013年第10期1602-1606,共5页Chinese Journal of Medical Imaging Technology

基　　金：河北省卫生厅重点科研计划(20110334)

摘　　要：目的探讨MR形态学测量鉴别诊断帕金森叠加综合征(PPS)与帕金森病(PD)的价值。方法对31例多系统萎缩(MSA组)、8例进行性核上性麻痹(PSP组)、30例PD(PD组)和30名健康志愿者(对照组)行常规MR扫描,观察其影像学特征性,并行形态学测量。结果壳核低信号征及裂隙征多见于MSA组,桥脑十字征与小脑中脚高信号征仅见于MSA组,蜂鸟征多见于PSP,但敏感度与特异度均不高。PSP组小脑上脚宽度、中脑面积显著小于其他组,小脑中脚/小脑上脚宽度比、桥脑/中脑面积比明显高于其他组;MSA组小脑中脚宽度及桥脑面积显著小于其他组。磁共振帕金森指数(MRPI)在PSP与非PSP者中完全无重叠,其敏感度、特异度及准确率均为100%。结论磁共振形态学测量能为诊断与鉴别诊断PPS提供客观的量化依据。Objective To explore the diagnostic value of morphologic MRI in the differential diagnosis among different types of Parkinsonism-plus syndrome （PPS） and Parkinson disease （PD）. Methods Conventional MRI was performed in 8 patients with progressive supranuclear palsy （PSP group）, 30 patients with PD （PD group）, 31 patients with multiple system atrophy （MSA group） and 30 age-matched healthy volunteers （control group） to observe the abnormalities and assess brain atrophy through morphologic measurements. Results Putaminal hypointensity and slit sign were mainly observed in MSA group, while cruciform sign and middle cerebellar peduncle hyperintensity were only observed in MSA group. Humming bird sign was mainly observed in PSP group. Nevertheless, the sensitivity and specificity of the above signs were insufficient. Midbrain area and superior cerebellar peduncle width in PSP were significantly smaller and pons to midbrain ratio and middle cerebellar peduncle width to superior cerebellar peduncle ratio were larger than those in PD, MSA and control group. Pons area and middle cerebellar peduncle width in MSA were significantly smaller. Only MR Parkinsonism index could discriminate completely between PSP and non-PSP without any overlap, the specificity, sensitivity and accuracy were all 100%. Conclusion Morphologic MRI can provide objective and quantitative criteria for differential diagnosis of PPS, therefore having important application value in clinical practice.

关 键 词：帕金森病 进行性核上性麻痹 多系统萎缩 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.5[医药卫生—诊断学]