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

ZHENG Kui-hong1; QI Xiao-kun2; LIU Jian-guo2; GUO Yong2; HUANG Min-hua2; MA Lin1

Journal of China Clinic Medical Imaging ›› 2017, Vol. 28 ›› Issue (5) : 305-308.

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)

Author information +

History +

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.

Key words

Multi system atrophy / Parkinson disease / Magnetic resonance imaging

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

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

References

[1]Stefanova N, Bucke P, Duerr S, et al. Multiple system atrophy: an update[J]. Lancet Neurol, 2009, 8(12): 1172-1178.
[2]Horimoto Y, Aiba I, Yasuda T, et al. Longitudinal MRI study of multiple system atrophy—when do the findings appear, and what’s the course?[J]. J Neurol, 2002, 249(7): 847-854.
[3]Ramli N, Nair SR, Ramli NM, et al. Differentiating multiple-system atrophy from Parkinson’s disease[J]. Clin Radiol, 2015, 70(5): 555-564.
[4]Atsuhiko S, Shoichi I, Sakurai T, et al. Putaminal hypointensity on T2*-weighted MR imaging is the most practically useful sign in diagnosing multiple system atrophy: A preliminary study[J]. J Neurol Sci, 2015, 349(1-2): 174-178.
[5]JFeng JY, Huang B, Yang WQ, et al. The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson’s disease?[J]. Acta Radiol, 2015, 56(3): 322-328.
[6]Lee WH, Lee CC, Shyu WC, et al. Hyperintense putaminal rim sign is not a hallmark of multiple system atrophy at 3T[J]. AJNR, 2005, 26(9): 2238-2242.
[7]Ito S, Shirai W, Hattori T. Putaminal hyperintensity on T1-weighted MR imaging in patients with the Parkinson variant of multiple system atrophy[J]. AJNR, 2009, 30(4): 689-692.
[8]Gilman S, Wenning GK, Low PA, et al. Second consensus statement on the diagnosis of multiple system atrophy[J]. Neurology, 2008, 71(9): 670-676.
[9]Jankovic J. Parkinson’s disease: clinical features and diagnosis[J]. J Neurol Neurosurg Psychiatry, 2008, 79(4): 368-376.
[10]中华医学会神经病学分会帕金森病及运动障碍学组．帕金森病痴呆的诊断与治疗指南[J]．中华神经科杂志，2011，44（9）：635-637.
[11]Druschky A, Hilz MJ, Platsch G, et al. Differentiation of Parkinson’s disease and multiple system atrophy in early disease stages by means of I-123-MIBG-SPECT[J]. J Neurol Sci, 2000, 175(1): 3-12.
[12]Quattrone A, Nicoletti G, Messina D, et al. MR imaging index for differentiation of progressive supranuclear palsy from Parkinson disease and the Parkinson variant of multiple system atrophy[J]. Radiology, 2008, 246(1): 214-221.
[13]Guevara CA, Blain CR, Stahl D, et al. Quantitative magnetic resonance spectroscopic imaging in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy[J]. Eur J Neurol, 2010, 17(9): 1193-1202.
[14]Tang CC, Poston KL, Eckert T, et al. Differential diagnosis of parkinsonism: a metabolic imaging study using pattern analysis[J]. Lancet Neurol, 2010, 9(2): 149-158.
[15]Kim YJ, Ichise M, Ballinger JR, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP[J]. Mov Disord, 2002, 17(2): 303-312.
[16]Plotkin M, Amthauer H, Klaffke S, et al. Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients[J]. J Neural Transm, 2005, 112(5): 677-692.
[17]Pellecchia MT, Barone P, Mollica C, et al. Diffusion-weighted imaging in multiple system atrophy: a comparison between clinical subtypes[J]. Mov Disord, 2009, 24(5): 689-696.
[18]Wang Y, Butros SR, Shuai X, et al. Different iron deposition patterns of multiple system atrophy with predominant parkinsonism and idiopathetic Parkinson diseases demonstrated by phase-corrected susceptibility weighted imaging[J]. AJNR, 2012, 33(2): 266-273.
[19]Gupta D, Saini J, Kesavadas C, et al. Utility of susceptibility weighted MRI in differentiating Parkinson’s disease and atypical parkinsonian syndromes[J]. Neuroradiology, 2010, 52(12): 1087-1094.
[20]Haller S, Badoud S, Nguyen D, et al. Differentiation between Parkinson disease and other forms of Parkinsonism using support vector machine analysis of susceptibility-weighted imaging(SWI): initial results[J]. Eur Radiol, 2013, 23(1): 12-19.
[21]Lee JH, Kim TH, Mun CW, et al. Progression of subcortical atrophy and iron deposition in multiple system atrophy: a comparison between clinical subtypes[J]. J Neurol, 2015, 262(8): 1876-1882.