Department of Neurology, School of Medicine, National Yang-Ming University, #155, Sec.2, Linung St., Peitou District, 112 Taipei, Taiwan.
Neuroradiology. 2011 Jul;53(7):471-81. doi: 10.1007/s00234-010-0757-7. Epub 2010 Aug 25.
We performed diffusion tensor imaging to determine if multiple system atrophy (MSA)-cerebellar (C) and MSA-Parkinsonism (P) show similar changes, as shown in pathological studies.
Nineteen patients with MSA-C, 12 patients with MSA-P, 20 patients with Parkinson disease, and 20 healthy controls were evaluated with the use of voxel-based morphometry analysis of diffusion tensor imaging.
There was an increase in apparent diffusion coefficient values in the middle cerebellar peduncles and cerebellum and a decrease in fractional anisotropy in the pyramidal tract, middle cerebellar peduncles, and white matter of the cerebellum in patients with MSA-C and MSA-P compared to the controls (P < 0.001). In addition, isotropic diffusion-weighted image values were reduced in the cerebellar cortex and deep cerebellar nuclei in patients with MSA-C and increased in the basal ganglia in patients with MSA-P.
These results indicate that despite their disparate clinical manifestations, patients with MSA-C and MSA-P share similar diffusion tensor imaging features in the infratentorial region. Further, the combination of FA, ADC and iDWI images can be used to distinguish between MSA (either form) and Parkinson disease, which has potential therapeutic implications.
我们进行弥散张量成像以确定多系统萎缩（MSA）-小脑（C）和 MSA-帕金森病（P）是否存在类似的病变，这与病理学研究结果一致。
19 例 MSA-C 患者、12 例 MSA-P 患者、20 例帕金森病患者和 20 名健康对照者接受了弥散张量成像的基于体素形态计量分析。
与对照组相比，MSA-C 和 MSA-P 患者的中脑小脑脚和小脑的表观弥散系数值升高，锥体束、中脑小脑脚和小脑白质的各向异性分数降低（P<0.001）。此外，MSA-C 患者的小脑皮质和小脑深部核团的各向同性弥散加权图像值降低，MSA-P 患者的基底节区升高。
这些结果表明，尽管 MSA-C 和 MSA-P 患者的临床表现不同，但它们在小脑蚓部有相似的弥散张量成像特征。此外，FA、ADC 和 iDWI 图像的结合可用于区分 MSA（任何一种形式）和帕金森病，这具有潜在的治疗意义。
