颅脑MRI在帕金森病与帕金森综合征、多系统萎缩、进行性核上性麻痹鉴别诊断的意义  

Significance of MRI in the Differential Diagnosis of Parkinson's Disease and Parkinson's Syndrome,Multiple System Atrophy,and Progressive Supranuclear Palsy

作　　者：周雯[1] 徐德敏 张辉[1] 刘紫薇 黄金叶子 冯飞[1] ZHOU Wen;XU De-min;ZHANG Hui;LIU Zi-wei;HUANG Jin-ye-zi;FENG Fei(Department of Medical Imaging,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China)

机构地区：[1]北京大学深圳医院医学影像科,广东深圳518036

出　　处：《罕少疾病杂志》2021年第4期13-14,56,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的通过分析帕金森病(PD)与帕金森综合征、多系统萎缩(MSA)、进行性核上性麻痹(PSP)的颅脑MRI特点,探究MRI在以上疾病中的鉴别诊断价值。方法选取我院2020年1月至2021年2月收治的帕金森病与继发性帕金森综合征(PS)、多系统萎缩、进行性核上性麻痹患者各20例,对这些患者均进行颅脑MRI检查。采用目测法观察这些患者的颅脑MRI改变特点,采用不规则形面积软件系统测量这些患者中脑面积(M)、桥脑面积(P),并计算两者的比值(M/P)。结果目测MRI图像发现,MSA患者的桥脑、小脑明显萎缩发生率均为100%,与其他各组比较具有统计学差异;目测MRI图像发现,PSP组患者“蜂鸟征”发生率100%,与其他各组比较具有统计学差异;经面积测量后发现,PSP组患者中脑面积平均值最小(P<0.05),MSA组患者桥脑面积平均值最小(P<0.05),而在M/P值的比较上,PSP组患者的M/P值最小(P<0.05)、MSA组患者的M/P值最大(P<0.05)。结论通过对颅脑MRI进行比较、分析能够有效地将MSA、PSP与PD、PS区别开来。Objective To explore the value of MRI in the differential diagnosis of Parkinson's disease(PD),Parkinson's syndrome,multiple system atrophy(MSA),and progressive supranuclear palsy(PSP).Methods Gathered 20 patients with Parkinson’s disease,Parkinson’s syndrome(PS),multiple system atrophy,and progressive supranuclear palsy respectively.The MRI features were analyzed Retrospectively.The Midbrain area(M)and pontine area(P)of these patients were measured with irregular-shaped area software system,and the ratios of the two(M/P)were calculate.Results MRI images showed that the incidence of significant atrophy of the pons and cerebellum in MSA patients was 100%,which was statistically different from other groups;the incidence of"hummingbird sign"in PSP group was 100%.The average brain area in the PSP group was smallest,and the average pontine area in the MSA group was smallest,while the M/P value of patients in the PSP group was smallest,and the M/P value of patients in the MSA group was largest.Conclusion The analysis of MRI can effectively distinguish MSA and PSP from PD and PS.

关 键 词：颅脑MRI 帕金森病 帕金森综合征 多系统萎缩 进行性核上性麻痹 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]