帕金森病和非典型帕金森病的 MRI 征象。

MRI Signs of Parkinson's Disease and Atypical Parkinsonism.

机构信息

Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein - Campus Kiel, Germany.

出版信息

Rofo. 2021 Dec;193(12):1403-1410. doi: 10.1055/a-1460-8795. Epub 2021 May 25.

DOI:10.1055/a-1460-8795

PMID:34034347

Abstract

BACKGROUND

Diagnosis of Parkinson's disease and atypical parkinsonism is based on clinical evaluation of the patient's symptoms and on magnetic resonance imaging (MRI) of the brain, which can be supplemented by nuclear medicine techniques. MRI plays a leading role in the differentiation between Parkinson's disease and atypical parkinsonism. While atypical parkinsonism is characterized by relatively specific MRI signs, imaging of Parkinson's disease previously lacked such signs. However, high-field MRI and new optimized MRI sequences now make it possible to define specific MRI signs of Parkinson's disease and have significant potential regarding differentiated imaging, early diagnosis, and imaging of disease progression.

METHODS

PubMed was selectively searched for literature regarding the definition and discussion of specific MRI signs of Parkinson's disease, as well as the most common types of atypical parkinsonism with a leading motor component. No time frame was set, but the search was particularly focused on current literature.

RESULTS

This review article discusses the different MRI signs of Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy. The pathogenesis of the MRI signs is described, and imaging examples are given. The technical aspects of image acquisition are briefly defined, and the different signs are discussed and compared with regard to their diagnostic significance according to current literature.

CONCLUSION

The MRI signs of Parkinson's disease, which can be defined with high-field MRI and new optimized MRI sequences, enable differentiated structural image interpretation and consecutive diagnostic workup. Despite the fact that the signs are in need of further validation by bigger studies, they have the potential to achieve significant diagnostic relevance regarding the imaging of Parkinson's disease and atypical parkinsonism.

KEY POINTS

· High-field MRI and specialized sequences make it possible to define specific MRI signs for neurodegenerative disorders. · Cerebral alterations can be detected in prodromal stages of Parkinson's disease. · The combination of specific MRI signs makes it possible to differentiate between Parkinson's disease and atypical parkinsonism.

CITATION FORMAT

· Aludin S, Schmill LA. MRI Signs of Parkinson's Disease and Atypical Parkinsonism. Fortschr Röntgenstr 2021; 193: 1403 - 1410.

摘要

背景

帕金森病和非典型帕金森综合征的诊断基于对患者症状的临床评估和大脑磁共振成像（MRI），核医学技术可以对此进行补充。MRI 在帕金森病和非典型帕金森综合征的鉴别诊断中发挥着主导作用。虽然非典型帕金森综合征的特征是具有相对特定的 MRI 征象，但以前帕金森病的影像学缺乏这种征象。然而，高场 MRI 和新的优化 MRI 序列现在使得定义帕金森病的特定 MRI 征象成为可能，并在区分成像、早期诊断和疾病进展的影像学方面具有显著的潜力。