壳核背外侧异常信号在鉴别P型多系统萎缩与帕金森病中的诊断价值

郑奎宏1; 戚晓昆2; 刘建国2; 郭  勇2; 黄敏华2; 马  林1

中国临床医学影像杂志 ›› 2017, Vol. 28 ›› Issue (5) : 305-308.

郑奎宏1，戚晓昆2，刘建国2，郭勇2，黄敏华2，马林1

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Dorsolateral putaminal abnormality on magnetic resonance imaging in differentiating#br# parkinsonism-predominant multiple system atrophy from Parkinson’s disease

ZHENG Kui-hong1, QI Xiao-kun2, LIU Jian-guo2, GUO Yong2, HUANG Min-hua2, MA Lin1#br# (1.Department of Radiology, PLA General Hospital, Beijing 100853, China;#br# 2.PLA Navy General Hospital, Beijing 100048, China)

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摘要

[摘要] 目的：评价壳核背外侧异常信号在鉴别P型多系统萎缩（MSA-p）与帕金森病（PD）中的诊断价值。方法：对10例临床确诊的MSA-p型患者（MSA-p组）、20例年龄性别相匹配PD患者（PD组）行头颅常规MRI扫描及弥散加权成像。对各组每例患者的壳核萎缩、壳核背外侧弥散加权低信号及壳核背外侧裂隙征进行评价。结果：所有志愿者均顺利完成了上述检查，壳核异常信号常常见于MSA-p型患者。壳核萎缩征见于60%（6/10）MSA-p型患者，只见于10%（2/20）PD患者。MSA-p组80%（8/10）可见到壳核背外侧裂隙样T2加权高信号及弥散加权低信号征，明显高于PD组（0/20）。壳核背外侧异常信号在鉴别MSA-p与PD中的特异度达到100%，敏感度达80%。结论：壳核背外侧裂隙样T2加权高信号及弥散加权低信号是鉴别MSA-p与PD的特异性征象，具有重要的临床诊断价值。

Abstract

Abstract: Objective: To evaluate the diagnostic value of dorsolateral putaminal abnormality on magnetic resonance imaging(MRI) for differentiating parkinsonism-predominant multiple system atrophy(MSA-p) from Parkinson's disease(PD). Methods: Teen patients with MSA-p, 20 patients with PD were included. All subjects were examined with 3.0T MRI using the conventional and diffusion-weighted protocol. Putaminal atrophy, hypointensity on diffusion-weighted imaging(DWI) associated with a slit-like T2-hyperintense rim on the dorsolateral putamen were evaluated in each item. Results: Putaminal atrophy was found in 60% (6 of 10) of the MSA-p group, in only 10%(2 of 20) of the PD group. Dorsolateral putaminal abnormalities were seen in MSA-p(n=8) group, and none in PD group. The slit-like T2-hyperintense rim and the hypointensity on DWI in the dorsolateral putamen were seen in 80%(8/10) of the MAS-p group, which is significantly higher than PD group(0/20). The specificity and sensitivity of the dorsolateral putaminal abnormality for distinguishing MSA-p from PD was 100% and 80%, respectively. Conclusions: The signal changes including slit-like T2-hyperintense rim associated with hypointensity on DWI in the dorsolateral putamen are specific signs for differentiating MSA-p from PD.

导出引用

郑奎宏1，戚晓昆2，刘建国2，郭勇2，黄敏华2，马林1. 壳核背外侧异常信号在鉴别P型多系统萎缩与帕金森病中的诊断价值[J]. 中国临床医学影像杂志. 2017, 28(5): 305-308

ZHENG Kui-hong1, QI Xiao-kun2, LIU Jian-guo2, GUO Yong2, HUANG Min-hua2, MA Lin1. Dorsolateral putaminal abnormality on magnetic resonance imaging in differentiating#br# parkinsonism-predominant multiple system atrophy from Parkinson’s disease[J]. Journal of China Clinic Medical Imaging. 2017, 28(5): 305-308

中图分类号： Ｒ742 Ｒ445.2

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