Abstract
Background
We have established radiological protocol and made morphological measurement of the lentiform nucleus (LN) and the signal intensity which we used to discriminate parkinsonism predominant multiple system atrophy (MSA-P) from Parkinson’s disease (PD). But we don’t know whether it works especially in early stage of MSA-P. This case-control study aimed to investigate whether the new measurement of the morphological and intensity changes in susceptibility weighted imaging (SWI) of the LN could discriminate MSA-P from PD in their early stage and controls.
Methods
We retrospectively enrolled patients with MSA-P, PD, and sex- and age-matched controls between January 2015 and July 2020 at the Movement Disorder Center who underwent brain MR scanning with SWI sequence. Two specialists at the center reviewed the medical records and made the final diagnosis, and two experienced neuroradiologists performed MRI image analysis based on a defined radiological protocol to conduct the region of interest (ROI) based morphological measurements of the LN and the signal intensity.
Results
A total of 17 patients with MSA-P, 17 patients with PD within 2 years of the disease duration and 17 controls were enrolled in this study. We found that patients with MSA-P had significant decreased size in the short line (SL, cSL), and the ratio of the SL and the long line (SLLr, cSLLr) compared with the patients with PD and with the controls (P < 0.05). Combining these four indexes, this finding had a sensitivity of 58.8% and a specificity of 100% to distinguish MSA-P from PD.
Conclusions
As compared to PD and control subjects, the MSA-P patients are characterized by narrowing morphology of the posterior region of LN. The quantitative morphological change is a possible potential marker to differentiate MSA-P from PD in the early stage.
Differentiation of Parkinson’s disease and Parkinsonism predominant multiple system atrophy in early disease stages by means of objective measurement in Susceptibility Weighted Imaging