脑桥体积对多系统萎缩C型的诊断及鉴别价值  

Value of pontine volume in diagnosis and differential diagnosis of multiple system atrophy with predominant cerebellar ataxia

作　　者：李涛 吴翔 郭荷娜[2] 陈晓莉[2] 李妮妮 王沈阳 李伟[2] LI Tao;WU Xiang;GUO Hena(School of Medicine,Yan’an University,Yan’an 716000,China)

机构地区：[1]延安大学医学院,陕西延安716000 [2]陕西省人民医院神经内二科,陕西西安710068

出　　处：《中风与神经疾病杂志》2025年第1期23-29,共7页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 分析多系统萎缩小脑型(MSA-C)影像学的特定参数对临床诊断与鉴别的作用。方法 对陕西省人民医院2021年1月—2024年10月收治的34例MSA-C患者脑桥体积等影像学资料进行测量,并与进行性核上性眼肌麻痹(PSP)组9例、脊髓小脑性共济失调(SCA)组8例、正常组32例进行对比。结果MSA-C组与PSP组、正常组在脑桥体积方面差异有统计学意义(P<0.008 3),与SCA组差异无统计学意义(P>0.008 3);PSP组与SCA组、正常组在脑桥体积方面差异无统计学意义(P>0.008 3);SCA组与正常组在脑桥体积方面差异有统计学意义(P<0.008 3)。受试者曲线(ROC)提示脑桥体积在诊断MSA-C的截断值为8.66 cm^(3)(AUC为0.972,敏感度为94.12%,特异度为100%);鉴别MSA-C与PSP的截断值为8.66 cm^(3)(AUC为0.961,敏感度为94.1%,特异度为100%);鉴别MSA-C与SCA的截断值为6.79 cm^(3)(AUC为0.783,敏感度为52.94%,特异度为100%)。结论 脑桥体积作为评估脑桥萎缩最客观的指标,具有对MSA-C的诊断及鉴别价值。Objective To investigate the role of specific imaging parameters in the clinical diagnosis and differential diagnosis of multiple system atrophy with predominant cerebellar ataxia(MSA-C).Methods Imaging data including pontine volume were measured for 34 patients with MSA-C who were admitted to Department of Neurology,Shaanxi Provincial People’s Hospital,from January 2021 to October 2024,and these patients were compared with 9 patients with progressive supranuclear palsy(PSP),8 patients with spinocerebellar ataxia(SCA),and 32 normal controls.Results There was a significant difference in pontine volume between the MSA-C group and the PSP group,as well as between the MSA-C group and the normal control group(P<0.0083),while there was no significant difference between the MSA-C group and the SCA group(P>0.0083).There was no significant difference in pontine volume between the PSP group and the SCA group and between the PSP group and the normal control group(P>0.0083),and there was a significant difference in pontine volume between the SCA group and the normal control group(P<0.0083).The receiver operating characteristic(ROC)curve analysis showed that pontine volume had a cut-off value of 8.66 cm^(3) in the diagnosis of MSA-C,with an area under the ROC curve(AUC)of 0.972,a sensitivity of 94.12%,and a specificity of 100%;pontine volume had a cut-off value of 8.66 cm^(3) in the differential diagnosis of MSA-C from PSP,with an AUC of 0.961,a sensitivity of 94.1%,and a specificity of 100%;pontine volume had a cut-off value of 6.79 cm^(3) in the differential diagnosis of MSA-C from SCA,with an AUC of 0.783,a sensitivity of 52.94%,and a specificity of 100%.Conclusion As the most objective indicator for evaluating pontine atrophy,pontine volume has a great significance in the diagnosis and differential diagnosis of MSA-C.

关 键 词：多系统萎缩 共济失调 小脑中脚宽度 脑桥体积 

分 类 号：R741.04[医药卫生—神经病学与精神病学]