Diagnostic accuracy of MR planimetry in clinically unclassifiable parkinsonism
| Autor: | Klaus Seppi, Beatrice Heim, Gregor K. Wenning, Anna Hussl, Christoph Scherfler, Andrea Quattrone, Elke R. Gizewski, Stephanie Mangesius, Florian Krismer, Regina Esterhammer, Werner Poewe, Michael Schocke |
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| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine Neuroimaging Diagnostic accuracy Progressive supranuclear palsy Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Atrophy Mesencephalon Pons Humans Medicine Stage (cooking) Aged Retrospective Studies Third Ventricle Third ventricle medicine.diagnostic_test business.industry Parkinsonism Parkinson Disease Magnetic resonance imaging Middle Aged Multiple System Atrophy medicine.disease Magnetic Resonance Imaging eye diseases 030104 developmental biology medicine.anatomical_structure Neurology Female Supranuclear Palsy Progressive Neurology (clinical) Geriatrics and Gerontology Differential diagnosis business Nuclear medicine 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Parkinsonism & Related Disorders. 82:87-91 |
| ISSN: | 1353-8020 |
| DOI: | 10.1016/j.parkreldis.2020.11.019 |
| Popis: | Introduction Quantitative MR planimetric measurements were reported to discriminate between progressive supranuclear palsy (PSP) and non-PSP parkinsonism, yet few data exist on the usefulness of these markers in early disease stages. Methods The pons-to-midbrain area ratio (P/M) and the Magnetic Resonance Parkinsonism Index (MRPI) as well as new indices, termed P/M2.0 and MRPI2.0, multiplying the former by a ratio of the third ventricle (3rdV) width/frontal horns (FH) width, were calculated on T1-weighted images in 84 patients with clinically unclassifiable neurodegenerative parkinsonism (CUP) at the time of imaging. Areas under the curve (AUCs) of these markers for predicting future PSP was determined. The final clinical diagnosis was made after at least 24 months of follow-up. Results Final diagnosis was Parkinson's disease in 55 patients, multiple system atrophy in 12 cases, and PSP in 17. At baseline imaging, patients with a final PSP diagnosis had significantly higher MRPI, P/M, MRPI2.0 and P/M2.0 values compared to the other groups. AUCs in discriminating between future PSP and non-PSP parkinsonism were 0.91 for both the P/M and the MRPI and 0.98 for the P/M2.0 and the MRPI2.0. Conclusions Brainstem-derived MR planimetric measures yield high diagnostic accuracy for separating PSP from non-PSP parkinsonism in early disease stages when clinical criteria are not yet fully met. Consistent with the underlying pathology in PSP, our study suggests that inclusion of 3rdV width makes P/M2.0 and MRPI2.0 more accurate in diagnosing early stage PSP patients than the P/M and MRPI. |
| Databáze: | OpenAIRE |
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