Kim Byeong C, Choi Seong-Min, Choi Kang-Ho, Nam Tai-Seung, Kim Joon-Tae, Lee Seung-Han, Park Man-Seok, Yoon Woong
Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
National Research Center for Dementia, Gwangju, Korea.
Neurol Sci. 2017 Apr;38(4):627-633. doi: 10.1007/s10072-017-2812-1. Epub 2017 Jan 11.
Magnetic resonance (MR) measurements of brainstem structures have been reported to be useful in differentiating patients with progressive supranuclear palsy (PSP) from those with Parkinson's disease (PD). The aim of this study was to determine whether quantitative measurements of brainstem structures on MR images can help differentiate vascular parkinsonism (VaP) from degenerative parkinsonism (PD and PSP). Areas of the midbrain and pons, and widths of the superior cerebellar peduncle (SCP) and middle cerebellar peduncle (MCP) were measured in 62 patients with PD, 25 patients with PSP (11 probable and 14 possible), and 24 patients with VaP on T -weighted MR images. The midbrain-to-pons area ratio (M/P ratio), MCP-to-SCP width ratio (MCP/SCP ratio), and MR parkinsonism index (MRPI; P/M × MCP/SCP) were calculated. The midbrain area and M/P ratio of patients with VaP (104 and 0.22 mm, respectively) were smaller than those in patients with PD (121 and 0.24 mm, respectively) and larger than those in patients with PSP (90 and 0.19 mm, respectively). The MRPI was significantly larger in patients with PSP (13.6) in comparison with those with PD (10.1) and VaP (10.7). However, the MRPI of patients with VaP was not significantly different from patients with PD. Our study showed that MRPI was useful in differentiating PSP from VaP or PD. Thus, MR imaging measurements of brainstem structures may help differentiate patients with VaP from those with PD and PSP.
据报道，脑干结构的磁共振（MR）测量有助于鉴别进行性核上性麻痹（PSP）患者与帕金森病（PD）患者。本研究的目的是确定MR图像上脑干结构的定量测量是否有助于区分血管性帕金森综合征（VaP）与退行性帕金森综合征（PD和PSP）。在T加权MR图像上，对62例PD患者、25例PSP患者（11例可能病例和14例疑似病例）以及24例VaP患者的中脑和脑桥面积、上小脑脚（SCP）和中小脑脚（MCP）宽度进行了测量。计算了中脑与脑桥面积比（M/P比）、MCP与SCP宽度比（MCP/SCP比）以及MR帕金森综合征指数（MRPI；P/M×MCP/SCP）。VaP患者的中脑面积和M/P比（分别为104和0.22mm）小于PD患者（分别为121和0.24mm），大于PSP患者（分别为90和0.19mm）。与PD患者（10.1）和VaP患者（10.7）相比，PSP患者的MRPI显著更高（13.6）。然而，VaP患者的MRPI与PD患者无显著差异。我们的研究表明，MRPI有助于鉴别PSP与VaP或PD。因此，脑干结构的MR成像测量可能有助于区分VaP患者与PD和PSP患者。
