Paviour D C, Price S L, Stevens J M, Lees A J, Fox N C
Dementia Research Centre (UCL), Institute of Neurology UCL, London, UK.
Neurology. 2005 Feb 22;64(4):675-9. doi: 10.1212/01.WNL.0000151854.85743.C7.
Postmortem studies have shown atrophy of the superior cerebellar peduncle (SCP) to distinguish progressive supranuclear palsy (PSP) from other neurodegenerative diseases. It is not clear whether MRI-based measurements can differentiate this relative atrophy of the SCP during life.
Volumetric MRI was acquired prospectively in 53 subjects: 19 with PSP, 10 with multiple system atrophy (MSA), 12 with Parkinson disease (PD), and 12 healthy controls. SCP volume was assessed by detailed quantitative volumetric measurement and independently by blinded visual rating of SCP atrophy.
The mean SCP volume, corrected for total intracranial volume, was lower in patients with PSP than controls (p < 0.001), patients with MSA (p = 0.001), and patients with PD (p = 0.003). There was an overlap between individual SCP volume measurements in the PSP subjects and the other groups. Neuroradiologic rating correctly identified PSP cases based on the presence of SCP atrophy with a sensitivity of 74% and a specificity of 94%.
The authors propose that together with other radiologic features of progressive supranuclear palsy (PSP) such as midbrain atrophy, a visual assessment of the superior cerebellar peduncle may help increase the clinical diagnostic accuracy in PSP.
尸检研究表明，小脑上脚（SCP）萎缩可用于鉴别进行性核上性麻痹（PSP）与其他神经退行性疾病。基于MRI的测量方法在活体中能否区分SCP的这种相对萎缩尚不清楚。
前瞻性地对53名受试者进行了容积MRI检查：19例PSP患者、10例多系统萎缩（MSA）患者、12例帕金森病（PD）患者和12名健康对照者。通过详细的定量容积测量评估SCP体积，并由不知情的影像学专家对SCP萎缩进行独立的视觉评分。
校正总颅内体积后，PSP患者的平均SCP体积低于对照组（p < 0.001）、MSA患者（p = 0.001）和PD患者（p = 0.003）。PSP患者与其他组的个体SCP体积测量值存在重叠。神经放射学评分基于SCP萎缩的存在正确识别出PSP病例，敏感性为74%，特异性为94%。
作者提出，结合PSP的其他影像学特征如中脑萎缩，对小脑上脚进行视觉评估可能有助于提高PSP的临床诊断准确性。
