Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street Phipps B100F, Baltimore, MD 21287, USA.
University of Nebraska Medical Center, Department of Neurology, Omaha, NE 68198, USA; University of Nebraska Medical Center, Department of Ophthalmology, Omaha, NE 68198, USA.
Clin Imaging. 2019 Nov-Dec;58:170-176. doi: 10.1016/j.clinimag.2019.07.010. Epub 2019 Jul 24.
In a recent study, it was found that, although intrinsic midbrain signal abnormality (IMSA) on MRI is associated with Parinaud's syndrome (PS) in patients with pineal gland masses (PM), it had no predictive value with respect to resolution of PS. We sought to compare the PM and non-pineal etiologies (NPE) of PS by reviewing imaging features of PS and whether or not they are predictive of resolution of symptoms.
We reviewed electronic medical records from 1980 to 2017 and identified 71 patients with PS from any etiology who had MR imaging: 26 with PM and 45 with NPE. We subdivided the 45 NPE patients into those with intrinsic midbrain lesions (IMBL) (n = 23) and those with extrinsic midbrain lesions (EMBL) (n = 22). PS resolution and hydrocephalus data were collected. Imaging studies were reviewed for the presence of IMSA and hydrocephalus.
PS patients with EMBL were less likely to have IMSA than those with PM or IMBL (p ≤0.001). PS resolution occurred more commonly with PM than IMBL and NPE (p = 0.03, p = 0.01). For all NPE patients, resolution of PS occurred with equal frequency in patients with and without IMSA (p = 1.00). Hydrocephalus occurred more frequently in patients with PM and EMBL than IMBL (p = 0.01, p = 0.03).
IMSA is present more often in patients with PS from PM or IMBL than in patients with EMBL. EMBL, including PM, have an increased likelihood for PS resolution. There is no predictive value of IMSA with respect to resolution of PS in NPE as well as PM.
在最近的一项研究中发现，尽管 MRI 上的固有中脑信号异常（IMSA）与松果体肿块（PM）患者的 Parinaud 综合征（PS）相关，但它对于 PS 的缓解没有预测价值。我们试图通过回顾 PS 的影像学特征以及它们是否能预测症状的缓解来比较 PM 和非松果体病因（NPE）的 PS。
我们回顾了 1980 年至 2017 年的电子病历，从任何病因中确定了 71 例 PS 患者，他们都进行了 MRI 检查：26 例 PM，45 例 NPE。我们将 45 例 NPE 患者分为有固有中脑病变（IMBL）（n=23）和有外在中脑病变（EMBL）（n=22）的患者。收集了 PS 缓解和脑积水的数据。对影像学研究进行了 IMSA 和脑积水的存在的评估。
与 PM 或 IMBL 相比，EMBL 的 PS 患者出现 IMSA 的可能性更小（p≤0.001）。PM 比 IMBL 和 NPE 更常见 PS 缓解（p=0.03，p=0.01）。对于所有 NPE 患者，有无 IMSA 的患者 PS 缓解的发生率相同（p=1.00）。PM 和 EMBL 的患者比 IMBL 的患者更容易发生脑积水（p=0.01，p=0.03）。
PM 或 IMBL 引起的 PS 患者中 IMSA 比 EMBL 患者更常见。EMBL，包括 PM，PS 缓解的可能性更大。在 NPE 以及 PM 中，IMSA 对于 PS 缓解没有预测价值。
