Asato R, Akiguchi I, Masunaga S, Hashimoto N
Department of Radiology, Kyoto University Graduate School of Medicine, Japan.
J Neural Transm (Vienna). 2000;107(12):1427-36. doi: 10.1007/s007020070006.
To establish diagnostic magnetic resonance imaging (MRI) criteria for differentiating progressive supranuclear palsy (PSP) from multiple system atrophy (MSA), magnetic resonance images from eight patients with probable PSP, 30 with probable MSA (nine striatonigral degeneration (MSA-P) and 21 olivopontocerebellar atrophy (MSA-C)), and ten age-matched controls were retrospectively studied. Anteroposterior diameters in the midline sagittal T1-weighted image of the rostral (RMT) and caudal midbrain tegmentum (CMT), caudal pons and medulla were measured. Divergence of the red nuclei (RN) in the axial T2-weighted image was judged. All PSP images had a smaller RMT diameter than the lower limit of the normal range, showed RN divergence, and had a pontine diameter within the normal range. All MSA images had a CMT diameter within the normal range; no MSA images showed divergence of RN. Forty-four percent (4/9) of MSA-P and 76% (16/21) of MSA-C images had a pontine diameter smaller than the lower limit of the normal range. On basis of the results, we propose MRI diagnostic criteria for differentiating PSP from MSA.
为建立鉴别进行性核上性麻痹（PSP）与多系统萎缩（MSA）的诊断性磁共振成像（MRI）标准，我们对8例可能患有PSP的患者、30例可能患有MSA的患者（9例纹状体黑质变性（MSA-P）和21例橄榄脑桥小脑萎缩（MSA-C））以及10例年龄匹配的对照者的磁共振图像进行了回顾性研究。测量了延髓（RMT）和尾侧中脑被盖（CMT）、尾侧脑桥和延髓的中线矢状面T1加权图像中的前后径。判断轴位T2加权图像中红核（RN）的离散情况。所有PSP图像的RMT直径均小于正常范围下限，显示RN离散，且脑桥直径在正常范围内。所有MSA图像的CMT直径在正常范围内；没有MSA图像显示RN离散。44%（4/9）的MSA-P图像和76%（16/21）的MSA-C图像的脑桥直径小于正常范围下限。基于这些结果，我们提出了鉴别PSP与MSA的MRI诊断标准。
