进行性核上性麻痹头部磁共振的神经影像学特点①.PDF

- 446 - 中国康复理论与实践2011年5月第17卷第5期 ChinJRehabilTheoryPract,May2011,Vol.17,No.5 ·临床研究· 进行性核上性麻痹头部磁共振的神经影像学特点① 朴英善，冯涛 [摘要] 目的 探讨进行性核上性麻痹(PSP)患者头部磁共振检查的神经影像学特点，并与帕金森病(PD)进行比较。方法 对 17例PSP 患者和30 例PD 患者的常规MRI 检查进行回顾性形态学测量分析。结果 17例PSP 患者均可见矢状位T 加权像中脑上缘 1 平坦或凹陷，PD 患者仅有4 例( 13%)(P0.01) ；正中矢状位T 加权像上计算中脑断面面积以及中脑与桥脑断面面积比值，PSP 组均 1 低于PD 组(P0.01) ；PSP 组与PD 组的中脑前后径大小虽然存在差异，但是有明确的重叠现象；PSP 组轴位T 加权像上导水管腹侧 2 出现弥散性高信号，虽然具有较高的特异性，但是具有较低的敏感性。结论 MRI 检查中脑萎缩对PSP 具有较高的诊断价值，并 能与PD 相鉴别。 [关键词] 进行性核上性麻痹；帕金森病；磁共振成像 Features of MRI in Progressive Supranuclear Palsy PIAO Ying-shan, FENG Tao. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China Abstract: Objective To investigate the features of magnetic resonance imaging (MRI) in the brain of patients with progressive supranu- clear palsy (PSP). Methods 17 patients with PSP and 30 patients with Pakinson disease (PD) were retrospectively studied with MRI. Re- sults The atrophy of the midbrain tegmentum and hummingbird sign were demonstrated in all of the PSP patients studied, but were only flatness observed in 13% of PD patients. The area of the midbrain and the ratio of midbrain versus pons areas in the patients with PSP were significantly smaller than in those with PD. The average of midbrain transverse diameter in PSP was smaller than those in PD, but an over- lap was observed. Tegmental T2 hyperintensity had lower sensitivity. Conclusion MRI may be useful to distinguish