摘要
目的探讨多系统萎缩（MSA）患者在头部磁共振检查（MRI）的神经影像学特点，并与帕金森病（PD）进行比较。方法对13例MSA-C型患者、12例MSA．P型患者和30例PD患者的常规MRI检查进行回顾性形态学测量分析。结果MSA-C组桥脑断面面积及桥脑前后径大小明显低于PD组[桥脑断面面积：MSA-C组为（386．4±74．2）mm^2，PD组为（528．5±40．8）mm^2；桥脑前后径大小：MSA．C组为（17．9±1．8）mm，PD组为（20．24-1．4）mm]，2组比较差异均有统计学意义（t值分别为6．5、4．7，P均〈0．01），而MSA-P组[桥脑断面面积为（474．1±88．0）mm。，桥脑前后径大小为（19．3±2．4）mm]与PD组差异无统计学意义（P均〉0．05）；MSA-C组及MSA-P组小脑中脚大小均明显低于PD组，差异均有统计学意义[MSA-C组为（6．1±1．6）mm，MSA-P组为（6．5±1．2）mm，PD组为（9．1±1．0）mm，t值分别为6．2、7．1，P均〈0．01]，而MSA-C组与MSA—P组差异无统计学意义（P〉0．05）。MSA．C组MRI形态学表现中敏感性最高的是小脑萎缩，其次是桥脑十字征、小脑中脚高信号，但小脑萎缩特异性不高，桥脑十字征及小脑中脚高信号具有较高的特异性；MSA-P组MRI形态学表现中敏感性相对高一些的是壳核外侧高信号及壳核弥漫性高信号，但其特异性不高。结论MRI检查MSA形态学改变具有较高的诊断价值，并能与PD讲行蓉别诊断．
Objective To investigate the features of magnetic resonance imaging （MRI） in the brain of patients with multiple system atrophy （MSA） and compare with that in Parkinson Disease （PD）. Methods Thirteen patients with MSA-C, 12 patients with MSA-P, and 30 patients with Pakinson disease （PD） were retrospectively studied in terms of MRI data. Results The area of the pons in the patients with MSA-C （386.4 ± 74.2） mm^2 was significantly smaller than in those with PD （ 528.5 ±40.8） mm^2, as well as the average of the pons transverse diameter （ [ 17.9 ±1.8 ] mm in the patients with MSA-C and [ 20.2 ± 1.4 ] mm in PD patients） （ t =6.5 and 4.7,Ps 〈0.01）. The area of the pons in MSA-P patients （474.1±88.0）mm2 and the average of the pons tranverse diameter （ 19.3 ＋ 2.4） mm were similar to those of PD patients （ Ps 〉 0. 05 ）. The average width of middle cerebellar peduncles （MCP） in MSA-C （6.1 ± 1.6 ） mm and MSA-P （ 6.5 ± 1.2 ） mm were smaller than those in PD patients （ 9. 1± 1. 0） mm （ t = 6.2 and 7. 1, Ps 〈 0.01 ）, whereas there was no significant difference between MSA-C and MSA-P group （ P 〉 0.05 ）. Inthe MRI findings, cerebellar atrophy was the highest sensitive, and cruciform hyperintensity and hyperintensity of MCP followed. The MRI profiles were more specific for hyperintensity of cruciform and MCP than for cerebellar atrophy in MSA-C population. For MSA-P population, MRI was relatively sensitive for hyperintensity of rim of the putamen and putamen, but less sPecific. Conclusion The assessment of MRI may be nseful to diagnose and distinguish MSA from PD.
出处
《中国综合临床》
2011年第7期705-708,共4页
Clinical Medicine of China
