进行性核上性麻痹新的可靠的MRI诊断标准

New and reliable MRI diagnosis for progressive supranuclear palsy

Objective: To evaluate the area of the midbrain and pons on midsagittal MRI i n patients with progressive supranuclear palsy (PSP), Parkinson disease (PD), an d multiple- system atrophy of the Parkinson type (MSA- P), compare these appea rances and values with those of normal control subjects, and establish diagnosti c MRI criteria for the diagnosis of PSP. Methods: The authors prospectively stud ied MRI of 21 patients with PSP, 23 patients with PD, 25 patients with MSA- P, and 31 age- matched normal control subjects. The areas of the midbrain tegmentu m and the pons were measured on mid- sagittal MRI using the display tools of a workstation. The ratio of the area of the midbrain to the area of the pons was a lso evaluated in all subjects. Results: The average midbrain area of the patient s with PSP (56.0 mm2) was significantly smaller than that of the patients with P D (103.0 mm2) and MSA- P (97.2 mm2) and that of the age- matched control group (117.7 mm2). The values of the area of the midbrain showed no overlap between p atients with PSP and patients with PD or normal control subjects. However, patie nts with MSA- P showed some overlap of the values of individual areas with valu es from patients with PSP. The ratio of the area of the midbrain to the area of pons in the patients with PSP (0.124) was significantly smaller than that in tho se with PD (0.208) and MSA- P (0.266) and in normal control subjects (0.237). U se of the ratio allowed differentiation between the PSP group and the MSA- P gr oup. Conclusion: The area of the midbrain on mid- sagittal MRI can differentiat e PSP from PD, MSA- P, and normal aging.