Oishi Kenichi, Konishi Junya, Mori Susumu, Ishihara Hiroyuki, Kawamitsu Hideaki, Fujii Masahiko, Kanda Fumio
Division of Neurology, Kobe University Hospital, Kobe, Japan.
J Neuroimaging. 2009 Apr;19(2):127-31. doi: 10.1111/j.1552-6569.2008.00262.x. Epub 2008 Jun 28.
In patients with the cerebellar variant of multiple system atrophy (MSA-C), reduced fractional anisotropy (FA) has been reported in several brain areas. However, since previous studies have employed predetermined regions of interest (ROI), the brain areas showing the earliest alterations in FA are unknown. The sensitivity of detecting early-stage MSA-C and the time course of the FA reduction are also unknown. The purpose was to address these issues to determine the diagnostic value of FA for early diagnosis.
Twenty-one patients with MSA-C were investigated. Voxel-based FA analysis and morphometry were used to detect the differences between early-stage MSA-C and normal controls. An ROI-based FA analysis was also used to clarify the temporal profile.
From the early-stage, MSA-C patients exhibited reduced FA and white matter atrophy in the middle cerebellar peduncle, the inferior cerebellar peduncle, and the ventral pons. The FA of these areas decreased rapidly during the first few years after onset, after which a rather gradual reduction occurred. The receiver operating characteristics analysis revealed a high sensitivity and specificity for discriminating early MSA-C from normal controls.
FA measurement could potentially be used to make an early diagnosis and monitor progression in MSA-C patients.
在多系统萎缩小脑型（MSA-C）患者中，已有报道称多个脑区的分数 anisotropy（FA）降低。然而，由于先前的研究采用了预先确定的感兴趣区域（ROI），FA 最早出现改变的脑区尚不清楚。检测早期 MSA-C 的敏感性以及 FA 降低的时间进程也不清楚。目的是解决这些问题，以确定 FA 对早期诊断的诊断价值。
对 21 例 MSA-C 患者进行了研究。基于体素的 FA 分析和形态学测量用于检测早期 MSA-C 与正常对照之间的差异。还使用基于 ROI 的 FA 分析来阐明时间特征。
从早期开始，MSA-C 患者在小脑中脚、小脑下脚和脑桥腹侧表现出 FA 降低和白质萎缩。这些区域的 FA 在发病后的头几年迅速下降，此后下降较为缓慢。受试者工作特征分析显示，在区分早期 MSA-C 与正常对照方面具有较高的敏感性和特异性。
FA 测量有可能用于 MSA-C 患者的早期诊断和病情进展监测。
