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뇌 자기공명영상에서 뇌간과 소뇌 계측을 이용한 다계통위축증과 파킨슨병의 감별 진단

Measurements of Brain Stem and Cerebellum on Brain MRI: for the Differential Diagnosis Between Multiple System Atrophy and Idiopathic Parkinson's Disease

이명식|박지형|김현숙|홍지만|이기욱|나상준
대한신경과학회 (Korean Neurological Association)|2004.10|대한신경과학회지 (Journal of the Korean Neurological Association)|제22권 제5호|pp. 478-484

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참고문헌

주제분류신경과학

초록

Abstract

Background: Multiple system atrophy (MSA) and idiopathic Parkinson’s disease (IPD) are two common neurodegenerative disorders presenting with parkinsonism. Since a brain MRI study is an available method for differentiating MSA from IPD, we tried to find further values of brain MRI studies in differentiating MSA from IPD. Methods: We measured anteroposterior and transverse diameters (AD and TD, respectively) of the brain stem of T2-weighted axial images. We graded the severity of atrophy (grade 0: none; grade 1: mild; grade 2: moderate; and grade 3: severe) of cerebellar vermis and hemispheres on the midsagittal and parasagittal planes. Results: There were 36 patients with probable MSA and 40 patients with IPD. We calculated a parameter multiplying AD of the midbrain by TD of the midbrain. The mean of the AD x TD of the midbrain was 1007.5±161.8 mm2 in patients with MSA, and it was significantly smaller than that of those with IPD (1113.3±118.7 mm2). When the cut off value was decided as 1050 mm2, the sensitivity of the parameter for the diagnosis of MSA was 83.3% and specificity was 80%. The frequency of cerebellar atrophy was 72.2% in patients with MSA, and it was significantly higher than that of those with IPD (37.5%). Conclusions: Measurements of the brain stem, particularly the midbrain, and cerebellum areas on brain MRI are helpful methods for the differential diagnosis of patients with MSA from those with IPD.

참고문헌 (32)

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