Departments of Neurology, Inje University College of Medicine, Busan, Korea.
Radiology, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea.
J Mov Disord. 2009 Oct;2(2):64-8. doi: 10.14802/jmd.09017. Epub 2009 Oct 30.
Several studies have reported that diffusion-weighted imaging (DWI) is able to help discriminate a Parkinson variant of multiple system atrophy (MSA-p) from Parkinson's disease (PD) on the basis of the increased regional apparent diffusion coefficient (rADC). We analyzed the usefulness of DWI by using the rADC for differential diagnosis between MSA-p and PD and investigated the correlation between the rADC value and clinical features of MSA-p and PD.
Twelve patients with PD and 10 with MSA-p were studied. The rADC value was determined in different brain regions, including the dorsal putamen (DP) and middle cerebellar peduncles (MCP).
The rADC values of the DP showed a greater increase in MSA-p patients than in PD patients (p=0.03). MSA-p patients also presented increased rADC values of the MCP compared with PD patients (p=0.0001). In particular, the sensitivity, specificity and positive predictive values of the MCP rADC were higher than those of the DP rADC. However, DP and MCP rADC values were not correlated with clinical features in either MSA or PD patients.
DWI discriminated between PD and MSA-p based on rADC values in DP and MCP. The MCP rADC value, in particular, could better discriminate MSA-p from PD.
多项研究报告称，弥散加权成像（DWI）能够根据区域性表观弥散系数（rADC）的升高，帮助区分帕金森变异型多系统萎缩（MSA-p）与帕金森病（PD）。我们分析了 DWI 的 rADC 对 MSA-p 和 PD 进行鉴别诊断的有用性，并研究了 rADC 值与 MSA-p 和 PD 的临床特征之间的相关性。
研究了 12 例 PD 患者和 10 例 MSA-p 患者。在不同的脑区（包括背侧壳核（DP）和小脑中脑脚）确定 rADC 值。
MSA-p 患者的 DP rADC 值较 PD 患者明显增加（p=0.03）。与 PD 患者相比，MSA-p 患者的 MCP rADC 值也增加（p=0.0001）。特别是，MCP rADC 的敏感性、特异性和阳性预测值均高于 DP rADC。然而，DP 和 MCP rADC 值与 MSA 或 PD 患者的临床特征均无相关性。
DWI 通过 DP 和 MCP 的 rADC 值区分了 PD 和 MSA-p。特别是 MCP rADC 值能更好地将 MSA-p 与 PD 区分开来。
