Madetko Natalia, Alster Piotr, Kutyłowski Michał, Migda Bartosz, Nieciecki Michał, Koziorowski Dariusz, Królicki Leszek
Department of Neurology, Medical University of Warsaw, 03-242 Warsaw, Poland.
Department of Radiology, Mazovian Brodnowski Hospital, 03-242 Warsaw, Poland.
J Clin Med. 2022 May 10;11(10):2701. doi: 10.3390/jcm11102701.
Differential diagnosis of progressive supranuclear palsy remains difficult, especially when it comes to the parkinsonism predominant type (PSP-P), which has a more favorable clinical course. In this entity, especially during the advanced stages, significant clinical overlaps with other tauopathic parkinsonian syndromes and multiple system atrophy (MSA) can be observed. Among the available additional diagnostic methods in every-day use, magnetic resonance imaging (MRI) focused specifically on the evaluation of the mesencephalon seems to be crucial as it is described as a parameter associated with PSP. There is growing interest in relation to more advanced mesencephalic parameters, such as the magnetic resonance parkinsonism index (MRPI) and MRPI 2.0. Based on the evaluation of 74 patients, we demonstrate that only the mesencephalon/pons ratio and MRPI show a significant difference between PSP-P and MSA-parkinsonian type (MSA-P). Interestingly, this differential feature was not maintained by MRPI 2.0. The mesencephalon to pons ratio (M/P), MRPI and MRPI 2.0 were not found to be feasible for the differentiation of PSP-P from other atypical tauopathic syndromes.
进行性核上性麻痹的鉴别诊断仍然困难，尤其是帕金森病为主型（PSP-P），其临床病程相对较好。在这种情况下，尤其是在疾病晚期，可观察到与其他tau蛋白病性帕金森综合征和多系统萎缩（MSA）存在显著的临床重叠。在日常可用的其他诊断方法中，专门用于评估中脑的磁共振成像（MRI）似乎至关重要，因为它被描述为与PSP相关的一个参数。人们对更先进的中脑参数，如磁共振帕金森指数（MRPI）和MRPI 2.0的兴趣与日俱增。基于对74例患者的评估，我们证明只有中脑/脑桥比值和MRPI在PSP-P和帕金森型多系统萎缩（MSA-P）之间存在显著差异。有趣的是，MRPI 2.0并没有保持这种鉴别特征。中脑与脑桥比值（M/P）、MRPI和MRPI 2.0在区分PSP-P与其他非典型tau蛋白病综合征方面并不可行。
