Differential value of brain magnetic resonance imaging in multiple system atrophy cerebellar phenotype and spinocerebellar ataxias

被引:20
|
作者
Kim, Minkyeong [1 ,2 ]
Ahn, Jong Hyeon [1 ,2 ]
Cho, Yoonsu [2 ]
Kim, Ji Sun [1 ,2 ]
Youn, Jinyoung [1 ,2 ,3 ]
Cho, Jin Whan [1 ,2 ,3 ]
机构
[1] Samsung Med Ctr, Dept Neurol, Seoul, South Korea
[2] Samsung Med Ctr, Neurosci Ctr, Seoul, South Korea
[3] Sungkyunkwan Univ, Sch Med, Seoul, South Korea
关键词
CROSS BUN SIGN; DIAGNOSIS; PROGNOSIS; FEATURES; PATIENT; TYPE-2;
D O I
10.1038/s41598-019-53980-y
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Clinically differentiating multiple system atrophy cerebellar (MSA-C) phenotype and spinocerebellar ataxias (SCAs) is challenging especially in the early stage. We assessed diagnostic value of brain magnetic resonance imaging (MRI) in differentiating MSA-C and SCAs based at different disease stages (<3, 3-7, and >7 years of disease duration). Overall, 186 patients with probable MSA-C and 117 with genetically confirmed SCAs were included. Hot cross bun (HCB) signs and middle cerebellar peduncle (MCP) hyperintensities were exclusively prevalent in MSA-C compared to SCAs at <3 years (HCB, 44.6% versus 0.9%; MCP hyperintensities, 38.3% versus 0.9%, respectively). Sensitivity, specificity, and positive predictive value (PPV) for HCB signs to differentiate MSA-C from SCAs were 45%, 99%, and 99% and those for MCP hyperintensities were 68%, 99%, and 99%, respectively; considering both HCB signs and MCP hyperintensities, specificity and PPV were 100%. However, the differential value of MRI signs decreased over time. MCP widths were smaller and showed more significant decrease in MSA-C than in SCAs. In conclusion, pontine and MCP changes were exclusively prominent in early stage MSA-C rather than in SCAs. Therefore, we should consider disease duration when interpreting pontine and MCP changes in brain MRIs, which will help better differentiate MSA-C and SCAs.
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页数:7
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