Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago 683-8504, Tottori, Japan.
Neuroradiology. 2012 Sep;54(9):947-55. doi: 10.1007/s00234-012-1009-9. Epub 2012 Jan 25.
The clinical differentiation of Parkinson's disease (PD) from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) may be challenging, especially in their early stages. The aim of this study was to evaluate the utility of apparent diffusion coefficient (ADC) measurement to distinguish among these degenerative disorders.
Twenty-five MSA, 20 PSP, and 17 PD patients and 18 healthy controls were retrospectively studied. Axial diffusion-weighted and T2-weighted images were obtained using a 3-T MR system. Regions of interest (ROIs) were precisely placed in the midbrain, pons, putamen, globus pallidus, caudate nucleus, thalamus, superior cerebellar peduncle, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus, and the regional ADC (rADC) value was calculated in each ROI.
In MSA, rADC values in the pons, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus were significantly higher than in PSP, PD, and controls. Furthermore, rADC values in the posterior putamen were significantly higher in MSA than in PSP and controls. In PSP, rADC values were significantly higher in the globus pallidus and midbrain than in MSA, PD, and controls. Furthermore, rADC values in the caudate nucleus and superior cerebellar peduncle were significantly higher in PSP than in MSA and controls. In PD, there were no significant differences in the rADC values compared to in MSA, PSP, and controls in all regions.
Evaluation of rADC values in characteristic lesions in MSA, PSP, and PD by placing ROIs using 3-T systems can provide useful additional information for differentiating these disorders.
帕金森病（PD）与多系统萎缩（MSA）和进行性核上性麻痹（PSP）的临床鉴别可能具有挑战性，尤其是在早期阶段。本研究旨在评估表观扩散系数（ADC）测量值在这些退行性疾病中的鉴别作用。
回顾性分析了 25 例 MSA、20 例 PSP、17 例 PD 患者和 18 例健康对照者。使用 3.0T MR 系统获得轴向弥散加权和 T2 加权图像。在中脑、脑桥、壳核、苍白球、尾状核、丘脑、上小脑脚、中脑小脑脚、小脑白质和小脑齿状核中精确放置感兴趣区（ROI），并计算每个 ROI 的局部 ADC（rADC）值。
在 MSA 中，脑桥、中脑小脑脚、小脑白质和小脑齿状核的 rADC 值明显高于 PSP、PD 和对照组。此外，后壳核的 rADC 值在 MSA 中明显高于 PSP 和对照组。在 PSP 中，苍白球和中脑的 rADC 值明显高于 MSA、PD 和对照组。此外，尾状核和上小脑脚的 rADC 值在 PSP 中明显高于 MSA 和对照组。与 MSA、PSP 和对照组相比，PD 患者在所有部位的 rADC 值均无显著差异。
通过在 3.0T 系统中使用 ROI 评估 MSA、PSP 和 PD 特征性病变的 rADC 值，可以为鉴别这些疾病提供有用的附加信息。
