Department of Radiology, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey.
Department of Radiology, Faculty of Medicine, İstanbul Medeniyet University, Göztepe Süleyman Yalçın City Hospital, İstanbul, Turkey.
Turk J Med Sci. 2021 Dec 13;51(6):3053-3060. doi: 10.3906/sag-2107-86.
BACKGROUND/AIM: In this study, we aimed to evaluate whether morphological changes in the mesencephalon, which were previously described as a diagnostic tool for progressive supranuclear palsy, could be associated also with idiopathic normal pressure hydrocephal
Consecutive 52 patients with a possible diagnosis of idiopathic normal pressure hydrocephalus (32 female, mean age 73.6 years) and 40 controls (23 female, mean age 72.7 years) with similar demographic characteristics were included the study. The morphologic changes in mesencephalon, hummingbird sign, and the vascular compression to mesencephalon were noted. Besides, three independent observers evaluated the imaging parameters for idiopathic normal pressure hydrocephalus in magnetic resonance imaging. Inter-observer reliabilities for qualitative and quantitative data were assessed using the Cronbach’s alpha and intra class correlation coefficient. The correlation of the imaging parameters with each other was evaluated with Pearson correlation.
Hummingbird sign was found to be significantly more common among patients with idiopathic normal pressure hydrocephalus (p < 0.0001). A statistically significant correlation was found between hummingbird sign and vascular compression of patients in the study group (p < 0.0001). A substantial, good, and perfect agreement was found between observers at all levels except callosal angle (fair agreement).
Hummingbird sign can be used to support the diagnosis of idiopathic normal pressure hydrocephalus in addition to other radiological findings. A significant correlation between vascular compression and hummingbird sign in the patient group may explain the morphological changes in the mesencephalon that resemble the Hummingbird sign, which was previously described for progressive supranuclear palsy.
背景/目的：在本研究中，我们旨在评估先前被描述为进行性核上性麻痹诊断工具的中脑形态变化是否也与特发性正常压力脑积水相关。
连续纳入 52 例可能诊断为特发性正常压力脑积水的患者（32 名女性，平均年龄 73.6 岁）和 40 名具有相似人口统计学特征的对照组患者（23 名女性，平均年龄 72.7 岁）。记录中脑形态变化、蜂鸟征和中脑血管压迫。此外，三位独立观察者评估磁共振成像中的特发性正常压力脑积水的影像学参数。使用 Cronbach's alpha 和组内相关系数评估定性和定量数据的观察者间可靠性。使用 Pearson 相关评估影像学参数之间的相关性。
蜂鸟征在特发性正常压力脑积水患者中更为常见（p<0.0001）。在研究组中，蜂鸟征与患者血管压迫之间存在统计学显著相关性（p<0.0001）。除胼胝体角（中等一致性）外，观察者在所有级别均显示出大量、良好和完美的一致性。
除其他影像学发现外，蜂鸟征可用于支持特发性正常压力脑积水的诊断。患者组中血管压迫与蜂鸟征之间的显著相关性可能解释了类似于先前描述的进行性核上性麻痹的中脑形态变化。
